Complete a new registration form for EACH
child. Click on send
to submit your completed form.
Please complete the following form and click on the Send
By selecting "Send" the parent/guardian of the participant acknowledges that the participant was advised to seek medical approval and that clearance prior to participating in this program and that the participant further HOLD HARMLESS, agrees to defend, and indemnify THE LONG BEACH PUBLIC LIBRARY, its employees, agents, representatives, sponsors, members and volunteers from any loss, liability, or claims, and expenses incurred in defending against any claims, loss or liability, including but not limited to, personal injury, medical emergency, and the costs of attorney fees made by any individual or entity as a result of or arising in connection with, out of or in relation to their participation in the program.
Long Beach Public Library
Youth Services Program Registration Confirmation
What is the date of birth of the child? (required)