MS Humanities Prime Time Family Reading Program
Registration Form
Registration will be closed once MAX number of registered families has been reached.
Children must be accompanied by a parent or guardian
For more information contact Megan @ 601 798 5081
Participation is FREE
Email address *
Participating Parent or Guardian Name 1: *
Your answer
Address: *
Your answer
Phone: *
Your answer
Participating Parent or Guardian Name 2:
Your answer
Number of children attending ages 6 to 11: *
Names of children attending ages 6 to 11: *
Your answer
Number of children attending childcare ages 3 to 5:
Names of children attending childcare ages 3 to 5:
Your answer
Total number of attendees (including childcare):
Would you be interested in obtaining a library card from the Pearl River County Library system?
Would you be interested in borrowing books from the Prime Time Family Reading Program?
Will you be able to attend all six sessions (every Tuesday for a six week period)?
How did you hear about this program?
Your answer
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