Participant 1 Required Entering Grade (K-12) Required Allergies or special considerations Required *Participant 2 *Entering Grade (K-12) *Allergies or special considerations *Participant 3 *Entering Grade (K-12) *Allergies or special considerations Parent or Guardian Name Required Parent or Guardian Phone Number Required Parent or Guardian email address Required Emergency Contact Name Required Emergency Contact Phone Number Required Emergency Contact email address I hereby authorize Carnegie-Evans Public Library of Albia to contact me via email or by phone for information. Required I am confirming the enrollment of my child/dependent Summer Library Program of 2022 Beyond the Beaten Path and the contact information I provided is my own and is checked regularly. Required Submit
