Summer Programs Participant
Please fill out this form if any family members would like to be listed as Participants in the Nevins Library Children's Summer Programs.

Being a Participant enters you into our end-of-summer prize drawing, and each child Participant will receive a certificate of participation and a special surprise in the fall!

(Please note that filling out this form does NOT register you for specific programs this summer; please visit the "Events" tab on the library website to register for any that interest you.)

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Parent/Guardian first and last name: *
Parent/Guardian email: *
In the spaces below, please list information about each child Participant: name, age, grade (in the fall), and school (if none, please write N/A).
Child 1- Name (First and Last) *
Child 1 -Age *
Child 1- Grade (in the Fall) *
Child 1- School (in the Fall) *
Child 2-Name (First and Last)
Child 2 -Age
Child 2- Grade (in the Fall)
Clear selection
Child 2- School (in the Fall)
Child 3- Name (First, Last)
Child 3 -Age
Child 3- Grade (in the Fall)
Clear selection
Child 3- School (in the Fall)
Child 4-Name (First, Last)
Child 4 -Age
Child 4- Grade (in the Fall)
Clear selection
Child 4- School (in the Fall)
Child 5- Name (First, Last)
Child 5 -Age
Child 5- Grade (in the Fall)
Clear selection
Child 5- School (in the Fall)
Clear form
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