SHAKE, RATTLE AND ROLL REGISTRATION FORM

For adults and children ages 2-6.
Tune in to the magic of music. Enjoy stories that leap off the page with song, dance and rhythm instruments.
For added fun, each child will be given a special "shaker".

Please register each child and program separately.

Note: Form must be completed in full.

Today's Date: 

Winter Session: Monday, January 4, 2010 - Thursday, February 25, 2010
Monday	Tuesday	Wednesday	Thursday
Session L 10:30am Madison	Session N 10:30am Madison	Session I 10:30am Main	Session J 10:30am Main
Session H 1:00pm Main	Session O 1:00pm Madison
Session M 7:00pm Madison			Session K 7:00pm Main
First Choice: Select one Mon., 1:00pm - H Wed., 10:30am - I Thur., 10:30am - J Thur., 7:00pm - K Mon., 10:30am - L Mon., 7:00pm - M Tues., 10:30am - N Tues., 1:00pm - O Second Choice: Select one Mon., 1:00pm - H Wed., 10:30am - I Thur., 10:30am - J Thur., 7:00pm - K Mon., 10:30am - L Mon., 7:00pm - M Tues., 10:30am - N Tues., 1:00pm - O

*No waiting list for sessions marked as CLOSED.

Child's Name (first & last)
Parent's / Guardian's Name (first & last)
Street Address
City/State/Zip
Phone
Child's Date of Birth (Month/Date/Year)

The Library will notify you regarding your selection. If you have any questions about Story Time Registration,
please call (216) 226-8275 Ext 140.

 

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Children's & Youth Services