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Rusk County Texas
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2024 Summer Reading Program
Mt. Enterprise Library Registration
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Please tell us about the Responsible Party for the Reader(s) you are registering.
Responsible Party First Name:
required
Responsible Party First Name: is required
Responsible Party Phone:
required
Responsible Party Phone: is required
Responsible Party Last Name:
required
Responsible Party Last Name: is required
Responsible Party Mailing Address:
required
Responsible Party Mailing Address: is required
Responsible Party Mailing Address City:
required
Responsible Party Mailing Address City: is required
Responsible Party Mailing Address State:
required
Responsible Party Mailing Address State: is required
Responsible Party Mailing Address Zip Code:
required
Responsible Party Mailing Address Zip Code: is required
I am the Responsible Party for the child/children listed on this form.
required
YES
NO
I am the Responsible Party for the child/children listed on this form. is required
Alternate Contact First Name:
required
Alternate Contact First Name: is required
Alternate Contact Last Name:
required
Alternate Contact Last Name: is required
Alternate Contact Phone:
required
Alternate Contact Phone: is required
Child's First Name:
required
Child's First Name: is required
Child's Age
required
Child's Age is required
Child's Last Name:
required
Child's Last Name: is required
Child's Mailing Address:
required
Child's Mailing Address: is required
Child's Mailing Address City:
required
Child's Mailing Address City: is required
Child's Mailing Address State:
required
Child's Mailing Address State: is required
Child's Mailing Address Zip Code:
required
Child's Mailing Address Zip Code: is required
Child's Phone Number:
required
Child's Phone Number: is required
Child's School:
required
Child's School: is required
Child's Reading Level:
required
Please select:
Number of Titles
Timed Readers
Young Adult
Child's Reading Level: is required
Child's Grade in the Fall:
required
Please select:
Pre-Reader
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Child's Grade in the Fall: is required
PHOTO CONSENT:
I understand that the Mt. Enterprise Library may photograph, videotape, or audio record the events or activities in which I am (or my child is) participating. I give my permission for the library to use photographs, videotape, or audio recordings of me (or my child) for the purpose of promoting the library and its services/programs. I give my 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 (or my child’s) likeness.
PHOTO CONSENT:
required
I DO give consent.
I DO NOT give consent.
PHOTO CONSENT: is required
An additional child may be registered in this section. If you do not need to register an additional child, please scroll down to the "
NEXT
" button.
Child's First Name:
Child's Age
Child's Last Name:
Child's Mailing Address:
Child's Mailing Address City:
Child's Mailing Address State:
Child's Mailing Address Zip:
Child's Phone Number:
Child's School:
Child's Reading Level:
Please select:
Number of Titles
Timed Readers
Young Adult
Child's Grade in the Fall:
Please select:
Pre-Reader
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
PHOTO CONSENT:
I DO give consent.
I DO NOT give consent.
An additional child may be registered in this section. If you do not need to register an additional child, please scroll down to the "
REMIND Notifications
" button.
Child's First Name:
Child's Age
Child's Last Name:
Child's Mailing Address:
Child's Mailing Address City:
Child's Mailing Address State:
Child's Mailing Address Zip Code:
Child's Phone Number:
Child's School:
Child's Reading Level:
Please select:
Number of Titles
Timed Readers
Young Adult
Child's Grade in the Fall:
Please select:
Pre-Reader
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
PHOTO CONSENT:
I DO give consent.
I DO NOT give consent.
An additional child may be registered in this section. If you do not need to register an additional child, please scroll down to the "
REMIND Notifications
" button.
Child's Name:
Child's Age
Child's Last Name:
Child's Mailing Address:
Child's Mailing Address City:
Child's Mailing Address State:
Child's Mailing Address Zip Code:
Child's Phone Number:
Child's School:
Child's Reading Level
Please select:
Number of Titles
Timed Readers
Young Adult
Child's Grade in the Fall:
Please select:
Pre-Reader
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
PHOTO CONSENT:
I DO give consent.
I DO NOT give consent.
REMIND:
Get information, updates, and alerts for the Summer Reading Program at the M.E. Library by signing up for our Remind! You don’t want to miss out on all the fun events, crafts, and movies at this year’s program. REMIND is a free messaging subscription you can cancel at anytime; it only pertains to events happening at this year’s Summer Reading Program.
Text the code @
mtesrp
to 81010 to sign up or allow us to sign up for you below!
REMIND Notifications:
required
Please select:
YES - Sign me up so I don't miss any events!
NO - I'll take my chances or sign up on my own.
REMIND Notifications: is required
REMIND - Cell Phone:
This is only needed if you choose for us to sign you up for REMIND notifications.
How did you hear about our Summer Reading Program?
required
Please select:
Past Participant
Friend
Facebook
Library Website
Brochure
School Handout
Staff Member
Newspaper
Local Newstation
Other
How did you hear about our Summer Reading Program? is required
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