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Summer Reading Program Registration
Registration for the WPCL 2021 Summer Reading Program is optional, but will aid in our planning. Thank you!
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Name of Parent/Guardian (Last, First)
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Your answer
Email
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Your answer
Address
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Your answer
Phone number
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Your answer
Name of Child #1 (Last, First)
*
Your answer
Age of Child #1
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Your answer
Name of Child #2 (Last, First)
Your answer
Age of Child #2
Your answer
Name of Child #3 (Last, First)
Your answer
Age of Child #3
Your answer
Name of Child #4 (Last, First)
Your answer
Age of Child #4
Your answer
Permission to videotape and/or photograph. WPCL may photograph or videotape the events or activity which I am (or my child is) participating. I give my permission for WPCL to use photographs or videotape of me (or my child) for the purpose of promoting WPCL and its services/programs. 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)
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