Teddy Bear Picnic - Friday, March 9 @ 10:30 am (Ages 1.5-5)

 

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1. Child’s name or nickname (please indicate the name your child would like to have the librarian use when taking attendance)

Child’s name or nickname (please indicate the name your child would like to have the librarian use when taking attendance)

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2. Child's age

Child's age

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3. First and last name of Parent or Caregiver accompanying the child

First and last name of Parent or Caregiver accompanying the child

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4. Telephone

Telephone

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5. Telephone number of another parent/caregiver for emergencies

Telephone number of another parent/caregiver for emergencies

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6. Does your child have any health related problems or allergies to food, glue, crayons, etc.?

Does your child have any health related problems or allergies to food, glue, crayons, etc.?   yes

no

7. If you answered yes, please explain:

If you answered yes, please explain:

8. E-Mail Address (only if you prefer we contact you this way)

E-Mail Address (only if you prefer we contact you this way)