Richmond Memorial Library
2020 Youth Summer Reading Challenge

From July 1st to September 1st for infants to age 18. Challenge yourself to read for 15 minutes a day! Download our reading log (at end of sign-up) or create your own. Bring in your reading log on or after September 1st for a prize! Prizes will differ according to age. You MUST be registered in order to receive a prize.
Email address *
Name (First & Last) of Child #1: *
Age of Child #1: *
Name (First & Last) of Child #2:
Age of Child #2:
Name (First & Last) of Child #3:
Age of Child #3: (for additional children, see bottom of form)
In which school district do you reside? *
Phone: xxx-xxx-xxxx *
Best way to contact you: *
How did you hear about our Summer Reading Program? *
Name (First & Last) of Child #4:
Age of Child #4:
Name (First & Last) of Child #5:
Age of Child #5:
Name (First & Last) of Child #6:
Age of (First & Last) Child #6:
For additional children, please list their names & ages below:
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Nioga Library System. Report Abuse