Mayor’s Nights – End of Summer Reading Event:
Permission Form
I (print name) ____________________________ give permission for my teen
(print name) ________________________________ to attend the Lock-in on
Saturday, August 1st.
I consent…
On behalf of myself and my teen, I hereby expressly assume all risk of loss, injury or death which may result from or arise out of my
teen’s riding or traveling as set forth above. On behalf of myself and my teen, I agree to release, relieve, indemnify and hold
harmless the library (including its officers, agents, employees, and elected and appointed officials) against any and all claims,
demands, damages, judgments, costs and expenses, including reasonable attorney’s fees for the defense of such claims and
demands, arising out of or in any way connected with my child’s travel as set forth above, regardless of whether such claims, etc.
arise in transit or at the destination. I am aware that this form contains a release of liability and indemnity agreement which is
intended to be legally binding. I have read it, I understand it, and I sign it of my own free will.
Travel
I consent for my teen to ride in a vehicle contracted by the Kansas City Public Library for the purpose of traveling from the Library
Branches below to the Plaza Library. See travel schedule below. As the library will still be closed upon our return, please indicate
whether you will be picking your teen up or if they are able to walk home.
Library Branch
Central Library
Bluford Library
Southeast Library
North-East Library
Trails West Library
Leave
Leave at 5:10pm
Leave at 5:20pm
Leave at 5:40pm
Leave at 5:20pm
Leave at 5:40pm
Return
Return at 11:35pm
Return at 11:25pm
Return at 11:15pm
Return at 11:35pm
Return at 11:20pm
Photo/Video Release
The library will be taking photographs and video throughout the evening. By signing below you give your consent for
your teen to attend the event, and for any photograph/video they appear in to be used for promotional purposes.
Parent/Guardian Signature __________________________________________________________
Please return permission slip the Wednesday before the trip so we can have an accurate food count.
Emergency Contact Information:
Name _______________________________ Telephone number/s____________________________
Address ______________________________________
Name of person who will be providing a ride home to your teen on Saturday evening:
____________________________________________________________________
The ride’s phone # ________________________Relationship to teen: _____________________
OR initial here if your teen can walk home: _____________
Other information about your child that we need to know (medications, allergies, etc.):
Please return this form to your teen librarian and keep the following pages for your reference.
Space is limited on these trips. A signed permission form does not guarantee space on the trips.
Space is limited on these trips. A signed permission form does not guarantee space on the trips.
Mayor’s Nights, End of Summer Reading Event : Parent Information
Dear Parent/Guardian,
The Kansas City Public Library is hosting Club KC, an event sponsored by the Mayor’s Night programs
at our Plaza Library on Saturday, August 1st from 6:00pm – 11:00pm. All teens ages 12-18 may
attend, however teens must be between the ages of 12 and 18 and sign in at the door.
For teens this lock-in will include free food, free activities and much more!
Information about the Teen Trips:

Attendance will be strictly limited to teens, ages 12-18 only, all of whom must return the
attached permission form before attending. We will not be able to allow last-minute additions
who have not returned a permission slip and been notified by the teen librarian that they are
registered for the trip.


Adult members of the library staff will supervise the trips and will be in attendance for the entire event.
Transportation will be provided from the local branches and the times for that transportation are on
the permission slip.
Teens must have a permission form signed by a parent or legal guardian on file with the library.
Teens must be picked up from their branch by the time specified on the permission slip. Library staff is
not allowed to transport teens in personal vehicles; teens will need to have a ride home arranged in
advance. If a parent grants permission for the teen to walk home it is with the understanding that the
library is released from liability when the teen leaves the property.


We believe that this event will be an enjoyable, safe experience for our library teens. If you have any questions,
please feel free to contact us.
Sincerely,
[email protected], (816) 876-6637
Crystal Faris, Director of Youth and Family Engagement
[email protected], (816)701-3513
emergency contact during event 816-876-3118
Elena McVicar, Bluford Youth Services Librarian
[email protected], (816) 701-3689
emergency contact during event 316-288-3156
Laura Kirk, North-East Youth Services Librarian
[email protected], (816) 701- 3485
Amanda Barnhart, Trails West Teen Services
[email protected], (816) 701-8311
Gabi Otto, Southeast Teen Services
[email protected], (816) 701-3484
Wick Thomas, Plaza Teen Services
Summer Kick-off Lock-in: Rules



Jamie Mayo, Central Youth Services Manager
[email protected], (816) 701-3445
Absolutely no alcohol, tobacco, or other drugs are to be brought onto library property or the buses.
You must have a completed permission form. This must be turned in to a teen staff member at least
one day prior to the event.
Respect and Participation is expected. No violent, threatening, destructive or otherwise inappropriate
behavior toward other teens will be tolerated. Any teen breaking these rules or being otherwise
disruptive will be required to call a parent/legal guardian and will not be able to participate in future
trips.