2021 Summer Library Program Registration

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Please fill out this form to register your child/children for our Summer Library Program

Parent/Guardian Name *

County of Residence *

Phone Number *

Child's Full Name - age - grade finished in May of 2021 & t-shirt size *

Child's Full Name - age - grade finished in May of 2021 & t-shirt size

I understand that Haskell Township Library may photograph or videotape the events or activity in which I am (or my child is) participating. I give my permission for the library to use photographs or videotape of me (or my child) for the purpose of promoting Haskell Township Library and its services/programs on their social media platforms. I give my permission with the following understanding: No compensation of any kind will be paid to me (or my child) at this time or in the future for the use of my (or my child’s) likeness. *

Yes

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