Lake Worth, Florida.   The Art of Florida Living.

Juvenile Library Card Application Form

Name *
Local/Home Address *
City *
State *
Zip *
Local/Home Phone *
E-Mail
Date of Birth *
PIN number for online account access *
Parent's Name
Parent's Address
City
State
Zip
Parents Phone

Parents: the first box below MUST be checked. Please check other items to indicate the privileges you wish attached to this card.

I agree to accept full financial responsibility for all lost, late, or damaged materials checked out on my card. I understand that I must present the card each time I check out materials. I will give prompt notice of any change of address or phone number. If fines are not paid, I will not be able to use my library card.

I agree to allow my child (14 years of age or older) to check out videocassettes rated P, PG and PG-13. As the parent I also accept full financial responsibility for all lost, late or damaged videocassettes check out by my child. I also understand that I may cancel this privilege at any time.

Internet Access *
Please select which level of Internet access you would like your child to have:
I agree to allow my child (age 9 years or older) to use the Internet without my supervision. I also acknowledge that I have received a copy of the library`s COMPUTER USAGE POLICY.
I do not want my child to use the Internet at the library.


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