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Summer Reading Club Form- Canal Flats
Thank you for signing up for Summer Reading Club (SRC) in Canal Flats! We will meet four times over the summer at the Canal Flats Lions' Park
Please fill out this form so we have all the info we need. You only need to fill it out once for the summer. Once completed, your kids are welcome to drop-in to the weekly programs.
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* Indicates required question
What is the participant's full name?
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Your answer
How old are they?
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Choose
5 (must be finished Kindergarten)
6
7
8
9
10
11
12
What grade are they going into in September?
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Your answer
What is the guardian's name?
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Your answer
Guardian's phone number? Please leave a number you can be reached at during the SRC program.
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Your answer
Guardian's email address?
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Your answer
Does the participant have any allergies or special concerns we should know about?
Your answer
If you know which days you will definitely attend, please select below. You can always contact us if there are any changes or drop-in if you've filled this form out (but this way we know what to expect). SRC will take place from 11:15am-12:30pm at the Canal Flats Lions Park on the following dates.
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Tuesday, July 5
Tuesday, July 9
Tuesday, August 9
Tuesday, August 23
Required
The libraries sometimes takes photos for our websites, newsletters and social media channels. Do we have permission to take and post photos of the participant?
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Yes
No
Other:
SRC will be outside in the Community Park. Please send your child to the program with sunscreen already on, a hat, and water bottle. On the especially hot days, please bring clothes that are ok to get wet (for water balloons, etc.)
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Yes, I will send them with these items.
Other:
Required
This is a drop-off program. Let us know if the participant has permission to leave the park by themselves. Let us know if they have permission to leave with someone other than you (please leave name & phone number of that person). Let us know at the drop-off of any changes.
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Your answer
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