A Universe of Stories                                                                                                                                    Summer Reading Program 2019                                          
Etowah Carnegie Library
723 Ohio Avenue
Etowah, TN  37331
(423) 263-9475 - phone    (423) 263-4271 - fax
etowahcarnegielibrary@gmail.com
www.etowahlibrary.com

Program Dates:  June 4, 2019 through July 18, 2019

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Name *
I am registering for the following Summer Reading Program: *
Please choose which type of reader you are: *
Email Address (yours or your parent's) *
Phone Number *
How many books do you want to read or listen to this summer?
What outcome do you expect from of our Summer Reading Program? (improve reading level, learn about new things, make new friends, have fun, etc.)
I understand the Etowah Carnegie Library may photograph or video the events or activities in which I am (or my child is) participating.  I give my permission for the Etowah Carnegie Library to use photographs or videotape of me (or my child) for the purpose of promoting the Etowah Carnegie Library and its services/programs.  I give my permission with the following understanding:    No compensation of any kind will be paid to me (or my child) at this time or in the future for the use of my (or my child's) likeness.  (Permission is not required to participate in the Summer Reading Program.) *
Required
By signing below, I verify that I am at least 18 years of age and that I am the parent or legal guardian of the child listed on this form (if applicable).  I agree that my typed name below will serve as my electronic signature.   (If you are under 18, your parent or legal guardian must sign.) *
Comments (optional)
Please come by the Circulation Desk to pick up your Registration Bag which includes your Reading Log, Program Calendar, etc.
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