Temporary Child Library Card Online Application

How would you like to be notified when this card number is ready?*

Email (Please be sure to enter the correct email address in the box on this application form.)
Phone

Phone for notification*

Do you have a preferred time range for when you would like to be called?*

Yes
No

Start Time*

: HH

MM

End Time*

: HH

MM

Child's Name*

First Last

Birthdate*

Parent/Guardian's Name*

First Last

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Street Address (if different than mailing)

Street Address Address Line 2 City State ZIP Code

Phone (best number at which to reach you)*

Cell Phone

Email*

We will only use your email address to notify you of holds or items that are coming due.

Would you like to be notified of available holds and items coming due by text message? (Please note that your carrier's messaging fees my apply.)*

Yes
No

If you would like to be notified via text, please enter your mobile phone number:*

If you would like to be notified via text, what is your mobile phone carrier?

Would you like to have a list of items checked out automatically emailed to you each time you check out?*

Yes
No

I apply for the right to use The Brookfield Library. I promise to comply with all its rules, to return items I borrow promptly, to promptly pay fines for overdue items borrowed on my card, and to reimburse the library for any items which are lost or damaged while in my care. I will immediately notify the library of any change in my address, telephone number, and/or email address. BY ENTERING YOUR FULL NAME IN THE BOX BELOW, YOU AGREE TO THE ABOVE STATEMENT.*

*

I agree to the following:

I apply for the right for my child to use The Brookfield Library. I promise to comply with all its rules, to return items borrowed by my child promptly, to promptly pay fines for overdue items borrowed on my child's card, and to reimburse the library for any items which are lost or damaged while in my child's care. I will immediately notify the library of any change in my address, telephone number, and/or email address. I assume full responsibility for materials borrowed by my child.

BY CHECKING THIS BOX, YOU AGREE TO THE ABOVE STATEMENT.

Phone

This field is for validation purposes and should be left unchanged.