Warm your Hearts with Reading at Indian River Area Library Winter Reading Program 2021 Sign-Up
This will be from February 2 - 27th!  Everyone is welcome to participate. If you are an adult you can fill this form out yourself. If you are under 18 we need a parent to fill out the form. If you would like a paper copy please visit the Library. Once you sign up there will be a fun reading bingo card and folder to pickup in the library (or curbside) to keep track of your reading.  When completed, return your bingo card to the library to be entered into a raffle to win a prize for all age groups!
Sign in to Google to save your progress. Learn more
Untitled Title
Full name of participant *
Address *
Phone Number/Email *
If under 18, name of Parent or Guardian
Which program are you participating in? *
Do you have a Library Card?
Clear selection
Indian River Area Library occasionally uses photographs of patrons and events in its publications, on Facebook, or on its website. This form grants the Library permission to use your and/or your child's photo unless we hear otherwise from you. I hereby grant permission to the Indian River Area Library to use my and/or my child's photograph on its website, Facebook, or other official printed publications without further consideration, and I acknowledge the library's right to crop or treat the photograph at its discretion. I also acknowledge that the Library may choose not to use my photo at this time, but may do so at its own discretion at a later date. I also understand that once my image is posted on the Indian River Area Library website or Facebook page, the image can be downloaded. Therefor I agree to indemnify and hold harmless from any claims the following: Board of Trustees, Indian River Area Library and All Employees, Indian River Area Library Indian River Area Library reserves the right to discontinue use of the photos without notice. Please state in the comments whether you prefer you and/or your child are only identified by first name or not identified by name. If you prefer to not be photographed at all, please also state that in the comments (and possibly provide some defining characteristics so that we can recognize you in order to avoid photographing you!
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Indian River Area Library. Report Abuse