Libraries Rock! Summer Reading Program 2018
Tuesdays, Music Programs, 10:30am-11:30am
Thursdays, Maker Spaces, 1pm
Child's Name: *
Your answer
Child's Age: *
Your answer
Child Entering Grade: *
Parent/Guardian Name: *
Your answer
Contact/Emergency Phone: *
Your answer
Alternate Phone:
Your answer
Person Accompanying Child to Library: *
Your answer
Is the child an independent reader? *
Child's allergies? Fears? Swiss bank account number?
Your answer
Your signature will be required when you begin the program.
I understand CCPL (Crittenden County Public Library) may photograph or videotape the events or activities in which I am (or my child is) participating. I give my permission for CCPL to use photographs or videotape of me (or my child) for the purpose of promoting CCPL 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 CCPL events.
Permission granted? *
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