Parent's Permission Slip for Child's Library Card

If your school-aged child DOES NOT have a library card for the Monroe County Libraries, print this form and fill it out. The next time you, or your child, comes to the Marathon Library, give us this form and we’ll immediately make a card out for your child.

Monroe County Public Library
George Dolezal Branch
3251 Overseas Highway
Marathon, FL 33050
743-5156 / 289-6098
fax: 289-6093
Gloria Goodman, Branch Manager

TO BE FILLED OUT BY PARENT OR GUARDIAN

Please give a library card to my SON or DAUGHTER so they can borrow books from the Public Library. I promise to pay for any damage or loss my child causes. I will pay any fines justly charged.

Date: ________________
First name of child: _______________________
Middle name of child: _______________________
Last name of child: _______________________
Birth date of child: _______________________

First name of ADULT: _______________________
Last name of ADULT: _______________________
Phone # of ADULT: _______________________

Mailing address of ADULT:
Street: __________________________________
City: __________________________________

Adult’s signature:___________________________

http://gobbysml.blogspot.com/2006/12/parents-permission-slip-for-childs.html