Summer Reading Program Registration Form
Register for our Summer Reading Program and join us for a season of reading, learning, and fun. Please complete this form to enroll and help us tailor the experience to each participant.
Participant Information
Participant Full Name
First Name
Last Name
Age
Date of Birth
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Grade Level
Please Select
1
2
3
4
5
6
7
8
School Name
Parent/Guardian Information
Parent/Guardian Name
First Name
Last Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Reading Preferences
Favorite Book Genres
Adventure
Fantasy
Mystery
Science Fiction
Non-fiction
Comics/Graphic Novels
Favorite Books or Authors
Reading Level
Please Select
Beginner
Intermediate
Advanced
Program Participation
Preferred Activities
Reading challenges
Group reading sessions
Storytime events
Book discussions
Creative activities
Special interests or goals
Additional Notes
Additional comments or needs
Submit
Should be Empty: