Juvenile Library Card Application Form

Juvenile Library Card Application Form

Ages 0-15
After submitting this form online, you must visit the library with parent or guardian's ID and proof of address in order to obtain a card.
Child's Name*

First NameMiddle Name or InitialLast Name
Child's Birthdate*

MonthDayYear
Date
Name of Parent/Guardian*

First NameMiddle Name or InitialLast Name
Parent/Guardian Driver's License Number & State
Applicants under 18 can use a parent or guardian's ID number
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address (if different from home address)
Primary Phone Number*
Please enter a valid phone number.
Secondary Phone Number
Please enter a valid phone number.
Email
example@example.com
Notification Preference *
Mobile Carrier
Required if you selected text notifications
Would you like to receive periodic emails about library news, special events and activities?

YesNo
Please read carefully and sign below

for parents and/or guardians

Patrons under 16 years of age are considered Juvenile card holders. The signature of the parent or guardian assuming responsibility for the children's borrowing activity is required.

I agree to observe all rules established by the library and will be responsible for all materials borrowed on the card. I also agree to pay charges imposed for loss of or damage to library materials. I will notify the library if the card is lost or if I change my name or address. I verify that the information on this form is correct. By signing, I recognize that it is my responsibility, and not the library's, to regulate what my child checks out.
My child has permission to access the Internet while in the library, and I understand that their usage will not be supervised.*

YesNo
Signature*

Clear
Should be Empty:

Please read carefully and sign below