Program Registration Thank you for taking interest in our program! Please give us little information about you and we will get back to you right away! Contact Name * Please give us first and last name of the person we will be contacting if there is changes to this program. (Parent, Guardian, Adult participant etc.) Participant(s) Name and Age (if under 16) * Please give us the participant's name and age. If there is more than one participant please separate with a ; (example: Dorothy Gale- 15; Matilda Wormwood -7; Valerie Fizzle) Phone number * E-mail address * Which program would you like to sign up? * Family Story- time Friday October 6th 10:30am Random Act of STEM - Ages 8-12 - October 10th Family Story- time Friday October 13th 10:30am Random Act of STEM - Ages 8-12 - October 17th Accessible Activity - October 19th - Adults with Disabilities Family Story- time Friday October 20th 10:30am Random Act of STEM - Ages 8-12 - October 24th Halloween Storytime Saturday October 28th 10:30am Family Story- time Friday October 27th 10:30am Random Act of STEM - Ages 8-12 - October 31st Random Act of STEM - Ages 8-12 - November 7th Other information Use this space freely to either ask us a question regarding program(s) that you are signing up for or give us information, how many participants in each program. Leave Blank
Thank you for taking interest in our program! Please give us little information about you and we will get back to you right away!
