YS Program Question Title * 1. Child’s name or nickname (please indicate the name your child would like to have the librarian use when taking attendance) Question Title * 2. Child's age Question Title * 3. First and last name of Parent or Caregiver accompanying the child Question Title * 4. Telephone Question Title * 5. Emergency Telephone Question Title * 6. Does your child have any health-related problems or allergies (food, crayon, glue, etc.) that would limit class participation? Yes No Question Title * 7. If you answered yes, please comment: Question Title * 8. E-Mail Address (only if you prefer we contact you this way) Question Title * 9. I understand that parents/caregivers must remain in the library at all times with children aged ten and under. I agree Click Here When Finished >>