Bruni Teen Volunteer Program Name(Required) First Last Email(Required) Phone(Required)Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date of birth(Required) MM slash DD slash YYYY Age(Required)What grade are you in?(Required)5th6th7th8th9th10th11th12thParent or legal guardian name(Required) First Last Location(Required) I understand that this program is at the Bruni Plaza Branch LibraryBruni Plaza Branch Library 1120 San Bernardo Laredo, TX 78040Registration Confirmation(Required) I understandRegistration for each program is limited and on a first come, first served basis. A library staff member will be in contact within one business day to confirm your registration.Release(Required) I agreeFor all programs, children under the age of fourteen (14) years must be accompanied by an adult. By enrolling your child, you give the City of Laredo permission to reproduce and publicize pictures or news articles pertaining to the Library as long as it is not a confidential matter. Release I hereby give my permission for this child to attend the selected Library program. I understand that all reasonable precautions will be taken to provide a safe program experience for this child, and that in consideration thereof for myself and for this minor child, and for the heirs, executors, and administrators and assigns of myself and this minor child, I hereby release the City of Laredo and the Laredo Public Library and their employees and volunteers from any liability or causes of indemnity and hold harmless the City of Laredo.CAPTCHANameThis field is for validation purposes and should be left unchanged.
