Name: Address: Email: Home Number: Cell Number: Texting :YesNo School & Grade: Graduation Year from HS: Birthday (mm/dd/yy): Today's Date (mm/dd/yy): How did you hear about us? T-Shirt Size: Permission to photograph/videotape (Required) I understand that the Public Library of Catasauqua may photograph or videotape the events or activities in which my child is participating I give my permission for the Library to use photographs or videotape of my child for the purpose of promoting the Public Library of Catasauqua and its services/programs. Parent(s), please check your choice in the space provided. Sign then print your name with the date. Thank you. Yes, I give permission for the Library to use photos/video of my child/ren for the purposes stated above. Child Name : No – I do not give my permission to use photos or videos of my child. Parent’s name (by entering your name, you are providing an electronic signature) Date : If you experience any issues accessing the above online resources, please contact the library for further instruction.