Event Registration What event are you registering for?*Please give specifics of date and event you are registering for.How did you hear about The Dr. Sue Weisberg Children’s Library?Parent/Guardian InformationParent/Guardian Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cell Phone*Email* Number of Children1234Child InformationChild Name* First Last Hebrew NameDate of Birth* Date Format: MM slash DD slash YYYY Does your child have any allergies?*Child #2 InformationChild Name* First Last Hebrew NameDate of Birth* Date Format: MM slash DD slash YYYY Does your child have any allergies?*Child #3 InformationChild Name* First Last Hebrew NameDate of Birth* Date Format: MM slash DD slash YYYY Does your child have any allergies?*Child #4 InformationChild Name* First Last Hebrew NameDate of Birth* Date Format: MM slash DD slash YYYY Does your child have any allergies?*PaymentPayment AmountPlease enter payment amount to be charged.
