All Ages Winter Reading Program
January 18-February 27, 2021: 1 prize entry per book read, virtual event attended, or library activity completed!

If you're a parent filling out for a child, please use their name and age.
Participant's First and Last Name *
Age Range *
Phone Number (To contact you if you win a prize!) *
What town do you live in? *
Book Title and Author (You can add multiple books on one form if you'd like!)
Library Activities Completed
Virtual Library Events Attended (or watched if a video)
Check the box for the prize you want your entry to go toward (You can check more than one box. Remember 1 book read, event attended, or activity completed = 1 entry)
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy