Preschool Story Hour Registration Form (Ages 3 and Up)

2024-2025 Story Hour Registration Form
Child's Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth
Age
Parent(s)/Guardian(s)
Email
example@example.com
YesNo
If yes, allergic to
If another person besides parents will be bringing the child to Story Hour, please fill out the following information:
Person #1
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Person #2
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Publication Consent Form

Dear Parent/Guardian:

At some time during the year, the library, newspaper, or television may videotape or photograph activities at Story Hour. This form gives permission for the library to photograph or videotape your child.

As the parent(s)/guardian(s) of
Child's Name

First NameLast Name
I/we give the Metcalfe County Public Library permission to release my/our child's name, photography, audio/video production for publication to the general public concerning library and/or Story Hour events.
Parent(s)/Guardian(s) Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

2024-2025 Story Hour Registration Form