Pike County Public Library Summer Learning Registration Form
Child's Name *
Your answer
Child's Age *
Your answer
Program *
Parent Name *
Your answer
Parent Library Card # (Parents must have a PCPL Library Card) *
Your answer
Child's Library Card #
Your answer
Parent Phone *
Your answer
Parent Email *
Your answer
Photo Release Permission *
T-Shirt Order. $8 Child $10 Adult *
What size?
Payment Method
Parent/Guardian E-signature *
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service