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SRC Registration

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Primary Contact
Full name of primary contact person
Please provide an email. If patron has no email, please use branch email address.
If no valid email, please provide a phone number.
Participation Type
If you will only do the Reading Challenge
If you plan to only attend programs at any branch
If you plan to attend programs and participate in the Reading Challenge
Please select the branch that you will participate at most. 
Participant Name
Participant Name
Please enter the age group for this participant: 0-5, 6-11, or 12-18
If you need to enter more participants, please provide the name/age of each participant and use the "Add more participants" button to add more names. You can register up to 20 names.
CAPTCHA
10 + 4 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.