Caregiver's name (the person who will be a part of the program with the child/children) *
Your answer
Phone #: *
Your answer
Alternate Phone #:
Your answer
How did you hear about the program? *
Required
For this program, a clean and quarantined bag of supplies will be provided, to be picked up the week of Jan. 7th-10th. At which branch would you like to pick up your bag? *
Do you approve of screenshots being taken of your family during the program? *
Would you like to receive our bi-monthly library newsletter which includes information on upcoming children's programming? *
If you would like to add any other information, please do so here. Thank you!
Your answer
A copy of your responses will be emailed to the address you provided.