Children's Programs Registration

Exit this survey 

1. Child's Name:

2. Grade (or Age if registering for storytimes):

3. Parent's Name:

4. Library Card #:

5. Phone Number:

6. Email Address:

7. City of Residence:

8. I would like to register my child for the following Storytime:

9. I would like to register for the following programs (check all that apply):

10. How did you hear about our programs?

11. Would you like a weekly reminder? (Please choose yes/no AND phone/email)