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Summer Reading Program 2023
Find Your Voice!
Events each Tuesday in June at Dike City Hall - June 6, 13, 20 and 27 at 10am
Lunch will be provided after each program by local church groups
Geared toward children entering Pre-K through 6th grade
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电子邮件地址
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您的电子邮件
Name of Child(ren) - OK to list multiple children of family on 1 form
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您的回答
Age(s) of Child(ren) - if entering multiple children on form, please check all that apply
3
4
5
6
7
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13
其他:
Grade(s) entering next year (program is for Pre-K through 6th grade - younger children are welcome to attend with siblings, etc., but program is geared toward Pre-K through 6th). If entering multiple children on 1 form, CHECK ALL THAT APPLY
Pre-school
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
其他:
Parent/guardian Name
您的回答
Home Address
您的回答
Parent/Guardian Phone Number
*
您的回答
Parent/Guardian Email Address
您的回答
Emergency Contact Name (secondary to parent/guardian listed above)
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您的回答
Phone Number for Emergency Contact
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您的回答
Please list the total number of children attending.
1
2
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5
6
7
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I am the parent or legal guardian of the above listed child. I understand the Dike Public Library may photograph or videotape the events or activities in which my child will participate as part of Summer Reading Program during the month of June 2023. I give my permission for the library to use photographs and/or videos of my child during these activities for the purpose of promoting the library and its services/programs. I understand no compensation of any kind will be paid to me or my child at this time nor in the future for the use of my child's likeness. No child will be identified by name.
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