Book Reading Club Registration

Preferred Age Track

Track A (10–12) Track B (13–15)

Parent/Guardian Full Name

Parent/Guardian's Email

Parent's Phone Number

Mailing address to receive books

Preferred Method of Contact

Email Phone Either

Emergency Contact Name

Emergency Contact Phone

Relationship to Child

Consent for Child to Participate in the Book Reading Club

Yes, I give permission No

Permission for Photos/Videos (Optional)

Yes (for Rehoboth Springs use only) No

Any Allergies, Learning Needs, or Important Notes?

Acknowledgement Statement

I understand that the Rehoboth Springs Book Reading Club is a values-based program focused on character, leadership, and respectful discussion, and I agree to the participation guidelines.

How did you hear about this program?

Commitment Deposit Acknowledgement

I understand that a small refundable commitment deposit is required to support engagement and preparedness. I understand this is not a program fee.

Payment Method

I will submit the refundable commitment deposit (please send $25 via email to admin@rehobothsprings.ca after submitting your registration and send confirmation of payment to the same email address).

Book Reading Club Registration

Links

Our info

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