2012 Summer Reading & One-Cent Movie Registration Form


Summer Reading Registration
  1.  (required)
  2.  (required)
  3.  (required)
  4. The dates of the reading program are as follows: July 13, July 20, July 27, and August 3.
  5.  (required)
  6.  (required)
  7.  (required)
  8.  (required)
  9.  (valid email required)
  10.  (required)
  11.  (required)
  12.  (required)
  13. By checking the box below, I, the undersigned parent/gaurdian, do herby grant permission for my son/daughter/ward to receive neccesary first aid anr/or medical treatment in the event of an injury or illness while attending the Free Summer Reading program sponsored by Faith presbyterian Chuch, and I accept responsibility for the full payment for such medical treatment. I herby hold Faith Presbyterian Church and their representatives harmless in the exercise of this authority.