Registration for 2017 Summer Library Program: "Build a Better World"
Please use this online form to register your child for the Summer Library Program, "Build a Better World," that will be held at the Greenwood-Leflore Public Library and the Jodie Wilson Branch Library during the month of June. Check our website, www.glpls.com, to find out more information.
Name of Participant
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Mailing Address
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City and Zip Code
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Phone Number(s)
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Age of Child
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School
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Grade Entering in September, 2017
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Please select one:
What location will you be visiting to attend the Summer Library Program?
By selecting yes, I understand the Greenwood-Leflore Public Libraries may photograph or videotape the events or activity in which I am (or my child is) participating. I give my permission for the Library to use photographs or videotape of me (or my child) for the purpose of promoting the Greenwood-Leflore Public Library System 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.
Please select one:
By entering my first name and last name in the space below, and by completing this form, I certify this information is correct.
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