Robotic Companion Program Registration
Please complete the registration form below to reserve a space in the Robotic Companion Lending Program. Program is for special needs children ages 5-10.

***Parent/Caregiver required to attend information session covering basic set-up and use of robotic companion.

Program is limited to 1 robotic companion per family.  A library card number is required for registration.

Call 714-647-5231 for more information.

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Parent/Guardian Name *
Phone Number *
Email Address *
Student Name *
Student Age *
Parent/Guardian Library Card Number *
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