Parent Pledge

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Second Year

Parent Pledge
Year Two

First Name*

Last Name *

Email Address*

Child's First Name*

Child's Last Name*

Child's Birth Date*

MM/DD/YY

Child's Gender*

FemaleMale

Child's Home Address*

Street, City, State

Zip*

I pledge to read to my child daily.*

Read aloud daily

I pledge to visit my local library monthly.*

Visit library

I pledge to provide First Library documentation of my library visit.*

Original, copy or screenshot of check out receipt. Screenshot of borrowed books (dated return sticker must be clearly displayed). See below.

Library visit

I pledge to attend a library sponsored children's activity every other month. *

Story time, craft time, holiday time, movie time, etc.

Attend activity bimonthly

I pledge to provide First Library documentation of my library sponsored activity. *

Picture of activity or copy/screenshot of program with library stamp and date. (Ask checkout clerk to stamp and/or date flyer).

Library sponsored activity

My child's participation may be revoked at any time if documentation is not provided. *

I accept

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Thank you for your child's continued participation in the First Library program.

Yearly parent pledges are required for participation in the program. Please submit the form for your child's continued participation in our program.