2022 Story Hour 2 Empower Registration

1

Parent or Guardian

First Name

Last Name

2

Email

example@example.com

Confirm Email

3

Which Story Hour(s) Would You Like To Register For?

4

Child's Name

First Name

Last Name

5

Child's Age

6

Child's Gender

Female

Male

Non-binary

7

Is this child in foster care?

YESNO

8

Racial Makeup of Household - Choose all that apply

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or other Pacific Islander

White