Summer Reading Registration and Permission Form

Welcome to our 2024 Summer Reading Signup!

2024 Summer Reading Registration & Permission Form
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 will be held at the Kiowa County Courthouse in Eads, Colorado. See you there! Dates: June 26 and July 3, 10, & 17, 2024 Time: 1:00-2:30 PM
To be used in case of emergency and for Summer Reading notification purposes.
This is for Summer Reading notification purposes only.
If you answer 'Yes', you are agreeing that your child can borrow library items each week during the program, and that you are responsible for: maintaining a current library card in good standing with ALL applicable family members listed; ensuring items are well cared for; returning all items; and paying any/all charges on your account for damaged and/or lost items.
Feel free to contact us at 719-438-5581 or email kcpld.eads@gmail.com for assistance.
Please type your first and last name to electronically sign the form and indicate that all of the above information is correct, and that you agree to all the terms and conditions outlined on this form when you submit your registration.


By Submitting this Form:

  • I give permission for my child(ren) to attend the 2024 KCPLD SRP on June 26 and July 3, 10 & 17, 2024, from 1:00-2:30 PM at the Kiowa County Courthouse in Eads, CO. I understand the program will be held both inside the building & outside on the lawn.
  • I give permission for my child(ren) to interact in close proximity with multiple children in an indoor and/or outdoor area. 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(ren) 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.
  • KCPLD has my permission to photograph and/or videotape my child(ren), 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(ren)'s likeness.