Summer Reading 2022 Registration
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Parent/ Guardian First and Last Name *
Email *
Phone Number *
Registration 1
Participant's First & Last Name *
Grade going into this Fall *
Permission for minor's name/likeness to be used in media (no compensation is offered for use of likeness) *
Registration 2
Participant's First & Last Name
Grade going into this Fall
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Permission for minor's name/likeness to be used in media (no compensation is offered for use of likeness)
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Registration 3
Participant's First & Last Name
Grade going into this Fall
Clear selection
Permission for minor's name/likeness to be used in media (no compensation is offered for use of likeness)
Clear selection
Registration 4
Participant's First & Last Name
Grade going into this Fall
Clear selection
Permission for minor's name/likeness to be used in media (no compensation is offered for use of likeness)
Clear selection
Registration 5
Participant's First & Last Name
Grade going into this Fall
Clear selection
Permission for minor's name/likeness to be used in media (no compensation is offered for use of likeness)
Clear selection
Please fill form out again for additional participants
By entering my name below, I agree that I am registering myself or a minor child/children for whom I am responsible in the Valley Center Public Library Summer Reading Program. *
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