2020 Summer Reading Collaboration IMAGINE YOUR STORY Registration
Email address *
Participant Name *
Address *
Phone #
Grade in August
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Reading Goal (# of hours per week or # of books):
Permission to Videotape and/or Photograph----------- I understand the Carrollton and Norborne Public Library may photograph or videotape the events or activity in which I am (or my child is) participating. I give my permission for the Carrollton and Norborne Public Library to use photographs or videotape of me (or my child) for the purpose of promoting the Carrollton and Norborne Public Library and its services/programs. I give my permission with the following understanding: No compensation of any kind will be paid to me (or my child) at this time or in the future for the use of my (or my child’s) likeness. Permission is not required to take part in library events. *
Parent / Caregiver Name *
Parent / Caregiver Email
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