Libraries Rock! Registration
MOUNDRIDGE PUBLIC LIBRARY
Event Address: 220 Christian St / Moundridge KS 67107
Contact us at (620) 345-6355 or moundridgelib@gmail.com
***visit moundridgelibrary.com for complete events calendar***

IMPORTANT: PLEASE REGISTER EACH CHILD SEPARATELY

Child's Name (first and last) - REGISTER EACH CHILD SEPARATELY *
Your answer
Child's age and grade just completed *
Your answer
Parent/Guardian Name (first and last) *
Your answer
Email *
Your answer
Telephone Number *
Your answer
Story Hour: Preschoolers with Classroom Experience (select preferred session)
Reader's Camp: Completed Kindergarten or Completed First Grade (select preferred session)
Reader's Camp: Completed 2nd Grade or Completed 3rd Grade (select preferred session)
Junior Book Club: 4th through 8th Grade (select sessions your child will attend)
Summer Reading Program Feature Fridays - ALL AGES! (select sessions your child will attend)
Special medical needs: dietary needs, allergies, conditions/illnesses we should know about:
Your answer
Do we have permission to use your child's likeness in a photograph, video, or other digital media in library promotion materials, including web-based publications, without payment or other consideration? *
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