Participant - Read-A-Thon Form
Hello!

Thank you for your interest in joining us for the Read-A-Thon! We are so excited to have you join us!
This Read-A-Thon is for ALL AGES from infants to adults! So get your entire family involved and get reading with us!

This form is to help us keep track of everyone involved and make sure that you receive all the information needed for the Read-A-Thon and your read-a-thon "package" which will include a bookmark, read-a-thon logs, collection forms and information packet. Your packet can be emailed or picked up during the kick off event!!

We look forward to reading with all of you!!!

Email address *
BASIC INFORMATION
This should be basic information from an adult. If you will have kids reading along as well, please add them below.
Name *
First & Last Name of Adult 18+ years old
Your answer
Will you be a reader as well? *
Zip Code *
Your answer
Other Readers
Please list any and all readers below with the following information: Name, Age (if under 18 years old), Gender. This include infants or non-readers as it does count to be read to. So if you plan to read to anyone, they are able to participate as well.
Readers *
Your answer
Live Events
You do NOT need to attend these events to participate, however, we would love to have you there. This will help give us an idea of about how many people to expect.
Will You Be Attending? *
No
Yes
Maybe
Kick Off Event - Feb. 10th
Celebration Ceremony - Feb. 24th
You give PPCM permission to use your name and age for kids (and all those listed above) in advertising & Read-A-Thon information for PPCM if you are a top reader or donor. *
Please fill in your name as your signature & understanding
Your answer
You give PPCM permission to use your image (and all those listed above) if captured during any and all read-a-thon events that you attend for advertising purposes for PPCM through social media, website, email and media outlets. *
Please fill in your name as your signature & understanding
Your answer
THANK YOU
We look forward to reading with you! We will be in contact soon! In the mean time, be sure to follow the event on our Facebook Page!!
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