Imagine Your Story Summer Library Program 2020
JULY 6 - jULY 31
CHILD'S FIRST NAME *
CHILD'S LAST NAME *
GRADE COMPLETED *
MAILING ADDRESS
PARENT/CAREGIVER'S PHONE NUMBER/S *
Choose One *
DOES YOUR CHILD HAVE ANY ALLERGIES OR MEDICAL CONDITIONS THAT WE SHOULD BE AWARE OF? *
DO YOU GIVE PERMISSION TO HAVE YOUR CHILD'S PICTURE PUBLISHED IN THE LOCAL PAPER? *
DO YOU GIVE PERMISSION TO HAVE YOUR CHILD'S PICTURE PUBLISHED ON THE LIBRARY WEBSITE/FACEBOOK PAGE? *
PARENT/CAREGIVER'S SIGNATURE *
Submit
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