"Build a Better World" Summer Reading Registration Form
Please complete this form to enroll in our Summer Reading Program.
Name of Child (first & last)
Your answer
Grade completed this year (2017)
Your answer
Home/Cell Phone
Your answer
Work Phone
Your answer
Address
Your answer
Allergies or Special Health Concerns
Your answer
The Ness City Library has my permission to photograph and/or video my child during summer reading activities. Child's name may be used in the local newspaper, but will not be listed on the internet (facebook, twitter, or web page).
Required
I varify that the information in this form is correct. To complete registration please stop by the library to pick up your reading packet and schedule.
Required
Parent or Guardians Name
Your answer
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