Library Membership Form for School Visits

Today a reader, tomorrow a leader

If Red Deer Public Library is coming to your school (or if your school is coming to the library!), then you are in the right place! Please fill out the form below, and we will have a shiny new library card ready for your child during our visit!

**This form can also be used for any students and teachers in our two partner schools, Ecole Barrie Wilson School and St. Patrick's Community School.**

Please note that this form is only for students and teachers who are part of a planned library visit or tour, or those attending one of our two partner schools. If this is not the case, or if you are a parent looking to get your own library membership, please visit rdpl.org/membership instead.

In addition, if you are a school staff member who is not a resident of Red Deer, please visit rdpl.org/membership and click on ME Libraries under the Library Card Options section to learn how you can access Red Deer Public Library materials with your home library card.

Student/Teacher Membership Registration Form

"*" indicates required fields

School Name*

Ecole Barrie Wilson School

St. Patrick's Community School

Other

Grade*

Teacher's Name*

Application Type*

Student Membership

Adult Membership (School Staff – must be a City of Red Deer resident)

Child or Teen Membership*

Choose one. Child memberships allow access to the Children's collection ONLY. Teen memberships allow access to ALL library collections available for loan (with the exception of Adult Videogames).

Child Membership (under 12)

Teen Membership (Teen cards are issued at the age of 12. Teen cards for younger ages are at the discretion of the parent/guardian)

Name*

First Last

Child's Name*

First Last

Parent/Guardian Name*

First Last

Additional Parent/Guardian Name to Add to Account (optional)

First Last

Parent/Guardian Email*

Email*

Phone*

Date of Birth*

Child's Date of Birth*

Home Address*

Street Address Address Line 2 City Province Postal Code Country

Home Address (note: adult applicants must be City of Red Deer residents)*

Street Address Address Line 2 City Province Postal Code Country

Do you need a new card or to renew an existing card?*

For card renewals, please enter your library barcode number (if you have it).

Parent Identification*

Driver's license number and name as it appears on the license OR two other pieces of identification (social insurance numbers NOT accepted).

Terms and Conditions*

By completing this form, I agree to be responsible for all materials borrowed on all cards issued under this application and to abide by the rules and regulations of the library where it/they are used.

The personal information contained on this application is used to provide you with library services at Red Deer Public Library. It may be used to verify membership, collect fines or debts owing, provide information about library services, and for statistical purposes. It is collected under the authority of Section 33(c) of the Freedom of Information and Protection of Privacy Act and it is protected under this act. If you have questions on disclosures or use of this information, please ask your library.

I agree to the Terms and Conditions.

Name

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

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Library Membership Form for School Visits

Student/Teacher Membership Registration Form

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