ARTS & CRAFTS, presented by Health Educator Kelley Grippo

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Explore your creative side and make social connections through arts & crafts.

* Personal caregiver MUST accompany.

** OPEN TO CHILDREN WITH DISABILITIES TOO! **

11:00-12:00 PM

2nd & 4th Saturday (4th Saturday ONLY in summer)

New Milford Public Library

200 Dahlia Ave, New Milford, NJ 07646

(201) 262-1221

This program is sponsored by the Mid Bergen Regional Health Commission

Questions? Contact Kelley at kegrippo@njlincs.net

Email *

Full Name of Participant *

Email *

Type of Disability

What we need to be aware of

Participant's Town of Residence *

Full Name of Accompanying Caregiver *

Caregiver's Cell Phone *

Emergency Contact *

I agree to indemnify, hold harmless, and release the Borough of New Milford, its officials, and staff from any liability for property damage and/or personal injury resulting from participating in the program.
*

Participant: I agree

Caregiver: I agree

Required

I acknowledge that any photograph or recording taken of me during the program may be used for promotion, outreach, education, and/or documentation purposes by the New Milford Public Library.
*

Participant: I acknowledge

Caregiver: I acknowledge

I do not wish to take part in photos or videos

Required

Participant's Signature (print full name) *

Caregiver's Signature (print full name) *

A copy of your responses will be emailed to the address you provided.

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