Child's Name
*
First Name
Last Name
DATE
*
-
Month
-
Day
Year
Beginning on (Sunday)
DATE
*
-
Month
-
Day
Year
Ending on (Saturday)
How Many Minutes Did You Read This Week? (check box for total mins for week)
*
15 Minutes
30 Minutes
45 Minutes
60 Minutes
75 Minutes
90 Minutes
105 Minutes
120 Minutes
135 Minutes
150 Minutes
Other
List Title of Books from Library Used for Reading Minutes
*
Which Prize would you like to enter your name into? - See prize list PICTURES in Summer reading Menu on website. (remember, your name will only be entered into the prize you select- 1 section per week based on min. reading minutes)
Prize #1 City of Ember book & Movie
Prize #2 Back to school pack & book
Prize #3 Back to school pack book & earbuds
Prize #4 starwars bundle
Prize #5 Unicorn Bundle
Prize #6 Middle School Book & Movie
Prize #7 Back to school bundle book earbuds
Prize #8 Girl's room decor, jewlery, bag
Prize #9 Fortnite
Prize #10 Outdoor Fun 1 -waterballs
Prize #11 Book & Coloring items
Prize #12 Bathbomb kit and cards
Prize #13 Light up chalkboard, purse, jewlery holder
Prize #14 Outdoor magnetic dart game
Prize #15 Pickball set
Prize #16 Outdoor fun2 - kite, balls, plane
Parent/Guardian's Signature
*
Submit
Should be Empty: