Caregiver's name (the person who will be bringing the child) *
Your answer
Phone #: *
Your answer
Alternate Phone #:
Your answer
What dates would you like to come? Note that some weeks have reached capacity but if you add your name to our waiting list for that specific week we may be able to accomodate you. *
Required
How did you hear about the program? *
Required
Does your child have any allergies or medical concerns you would like to tell us about?
Your answer
Do you approve of photos being taken of your child for usage in library media? *
Would you like to receive our monthly library newsletter which includes information on upcoming children's programming? *
If you would like to add any other information, please do so here. Thank you!