Clear the Shelves!

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Clear the Shelves!

Permission Form for Pembroke; Please complete a form for each student.

Pembroke Library would like to invite you to help us “Clear the Shelves” this summer to encourage broad, self-selected reading for our students. Participation is optional. Below are a few guidelines:
-Accounts must not have any lost book fines or unreturned books by June 3, 2022.
-Each participating student (K-4) will visit the library during the week of June 6th. Participating students may check out up to 10 books of their choice for the summer.

Students must have parent permission which acknowledges you are responsible for these books and will return them the first week of school in the fall.
-Each student will receive a printed list of checked out titles.

Student First Name *

Student Last Name *

Student Grade (2021-2022 School Year) *

Kindergarten

First

Second

Third

Fourth

Parent/Guardian Full Name *

Parent/Guardian Email *

Parent/Guardian Phone Number *

I give my student permission to check out 10 books from Pembroke's Library the week of June 6, 2022. We will return all 10 books the week of August 29, 2022, when we return to Pembroke school. *

Yes

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