Waynoka Public Library Summer Reading Program
Registration
Child's Name
First Name
Last Name
Birth Date
-
Month
-
Day
Year
Date
Age
Grade as of September 2026
Gender
Male
Female
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you have an account to check out books with the Waynoka Public Library?
Yes
No
Parent/Guardian Information
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
PERMISSION TO RECORD AND/OR PHOTOGRAPH - I understand that the Waynoka Public Library and the City of Waynoka may record or photograph the event or activity in which my child is participating for the purpose of promoting its services and programs. I give 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 child's likeness.
*
Yes
No
Confirmation
By acknowledging and submitting this form, I am delivering an electronic signature that will have the same effect as an original manual paper signature. The electronic signature will be equally as binding as an original manual paper signature.
Submit
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