First Name: * Middle Name: Last Name: * Birth Date (dd/mm/year): * Parent / Guardian First Name: * Parent / Guardian Last Name: * Mailing Address (Example: RR#2 or PO Box 123, etc.): * Civic Address: * City: * Province - Nova Scotia Only * Postal Code: * Telephone number where you prefer to be contacted (10 digits required): * Another Telephone Number, if desired: Email Address: NOTE: by providing an e-mail address, you are granting permission for your personal library information to be communicated to this address. (Example: notices about loaned material) Municipal area of residence, please choose one: * Annapolis CountyKings CountyDistrict of West HantsTown of Annapolis RoyalTown of BerwickTown of KentvilleTown of MiddletonTown of WindsorTown of WolfvilleOther If you are a seasonal resident, please provide your other mailing address (for mail out notices, etc.): Civic/Mailing Address: City: Province: Postal Code: The location where you would prefer to pick up material, please choose one: * Annapolis RoyalBerwickBookmobile & Off-Site ServicesBridgetownHantsportKentvilleKingstonLawrencetownMiddletonPort WilliamsWindsorWolfville I, as the parent/guardian (enter name below), * understand that I am responsible for all library materials that my child reads or views. I agree to take responsibility for the materials borrowed on this card and to abide by the rules and regulations of the Regional Library. Review our Privacy Policy. Submit
