JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Beardstown Houston Memorial Library Summer Reading Program
Please complete the following to register your child for our 2021 Summer Reading Program
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Child's Name
Your answer
Parent/Guardian's Name
Your answer
Address
Your answer
Phone
Your answer
Email
Your answer
Age/Grade
Your answer
Does your child have any allergies?
Your answer
I give permission for my child to be photographed and for the pictures to be used by the library in its local, public service publicity.
Yes
No
Clear selection
I give permission for my child to participate in activities held outside on the library grounds. These activities may include getting wet and/or dirty. Play clothing should be worn.
Yes
No
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
