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Click Submit when you're done to record your answers.

Please Print:

* 1st Preschool Child's FULL Name

* 1st Preschool Child's Birthdate

1st Child's Gender

Male

Female

2nd Preschool Child's FULL Name

2nd Preschool Child's Birthdate

2nd Child's Gender

Male

Female

* Parent/Guardian's Name

Parent/Guardian's Phone

Parent/Guardian's Email Address

* Child's Home Address

Mailing Address (if different)

"This child is a resident of Bartow, Ft. Meade, Lake Wales, Lakeland, or Winter Haven" --By clicking "submit", you are electronically signing this form and agreeing with this statement.

Privacy Statement: This information will not be used for any purpose other than the Imagination Library

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Upcoming Events

Apr 06/23 11:00 AM - 12:00 PM UWCF Executive Committee Meeting - 1st Thursday 11am-12pm, via Zoom

Apr 20/23 11:00 AM - 12:00 PM UWCF Board of Directors Meeting - 3rd Thursday 11am-12pm UWCF Office, Highland City FL w/Zoom Option

Apr 21/23 Day of Caring

Apr 27/23 05:00 PM - 09:00 PM A Night at the Ball Field

May 04/23 11:00 AM - 12:00 PM UWCF Executive Committee Meeting - 1st Thursday 11am-12pm, via Zoom

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Polk, Hardee and Highlands Counties, Florida | Phone: 863-648-1500 | PO Box 1357, Highland City, FL 33846 Physical Location

Dolly Parton Imagination Library Registration Form

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