Welcome to our 2021 Summer Reading Signup!

Please complete this form and agree to the terms before submitting. If you have more than one child to register, please use the boxes labeled additional child to enter their information. Sessions are on Wednesdays, June 30th, and July 7-21, from 1:00-2:00 PM on the Kiowa County Courthouse lawn in Eads, Colorado. See you there!
Please list Name, Age and "Grade going into" for each additional child
Please list Name, Age and "Grade going into" for each additional child
Please list Name, Age and "Grade going into" for each additional child
This is for notification purposes only.
Feel free to contact us at 438-5581 or email kcpld.eads@gmail.com for assistance

BY SUBMITTING THIS FORM
I give permission for my child to attend the 2021 KCPLD Summer Reading Program on June 30 and July 7, 14 & 21, 2021, from 1:00-2:00 PM on the Kiowa County Courthouse lawn in Eads, Colorado. I understand that this program involves exercise, movement, and being outdoors. I understand the Kiowa County Public Library District, and its staff and volunteers, are not liable for potential injuries. I agree that my child can participate in outdoor activities, as well as walk to other locations within Eads, CO (with library staff and volunteers present) to attend special events. I understand that KCPLD will notify me by note, phone, text, and/or email to inform me when and where a special event will occur.

I give permission for my child to interact in close proximity with multiple children in an outdoor area. I understand that, except for restroom use, there will be NO indoor activities/programs and that my child will NOT be checking out books inside the Library during the program. I understand KCPLD will adhere to mask and spacing requirements in effect at the time of each week’s program. I give permission for my child to accept a take-home “goodie bag” each week consisting of a personal, age-appropriate book and snacks. The snacks may or may not consist of fruit, granola bars, fruit snacks, nut bars, etc.

KCPLD has my permission to photograph and/or videotape my child, to use the pictures and/or videos for marketing purposes, and to post them on our website or social media sites like Facebook. I understand that no compensation of any kind will be paid now, or in the future, for the use of my child’s likeness.
Please type your first and last name to electronically sign the form and indicate your agreement to the above.