Summer Reading Sign-up & Media Release

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please use this form to sign up your children for the Summer Reading Program at the library.
Thursdays at 1:00 outside of the Menominee County's Library in Stephenson, or next door in the Stephenson Township Hall in inclement weather. Every Thursday in June. This is the permission slip and media release for the program.
Either a paper form or online form are required, not both.

Names and Ages of Children Attending *

Parent/Guardian Name, Address, Phone Number *

I, by submitting this form, do hereby grant or deny permission to the Menominee County Library to use the image, voice, and/or video of my child. Such use includes the display, distribution, publication, transmission, or otherwise use the images and or video of my child for use in materials that include but not limited to printed materials such as newsletters or newspaper, videos, and digital images such as those on Facebook. I understand my child’s image will never be sold or misused. *

Grant Permission

Deny Permission

By adding your name below, that will be considered as a signature for permission for your child to attend Summer Reading at the Menominee County Library. *

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms