PERMISSION SLIP FOR MPL TEEN AFTER HOURS
I, (print name) ________________________________________, do hereby give permission for the child in my care
(print name) _______________________________ to participate in the Minerva Public Library’s Teen After Hours
program on Friday June 24th, 2016 from 6:00 p.m. to 10:00 p.m.
I understand that this program will consist of a zombie library activity, video games, movie, teen fandom presentations
and other activities. I understand that this is a program after the library has closed for the evening, supervised by library
staff and adult volunteers. I grant my teen permission to participate in all activities.
I understand that this is a public program and photos may be taken during the event that could possibly be added to the
library’s Facebook and Instagram social media pages or published in the local newspaper.
I understand that my teen will be given the rules below and asked to follow them. If my teen misbehaves or breaks any
of the rules, I understand that any Minerva Public Library staff member has the right to ask my teen to leave the library.
If he or she is asked to leave I understand that I will be notified, and that I will be expected to pick them up immediately.
I have read the rules below and understand what is expected of my teen.
In addition, I understand that my teen is responsible for his or her own belongings and personal property. If my teen has
any food allergies, I will alert library staff.
In case of an emergency, or if my teen needs to be picked up before 10:00 pm, I would like the MPL staff to telephone
the following person:
_______________________________________________ , _____________________________
(Name)
(Relationship)
at
_____ - _____ - ________ (number)
LIBRARY AFTER HOURS RULES:
DO listen to all library staff and volunteers and do as you are asked.
DO stay out of staff areas, or other designated off-limits areas, of the library during the event.
DO respect others and take turns during gaming activities.
DO HAVE FUN and ask any staff member if you have questions!
Signed,
________________________________________________________ ____________________________
(Parent/Guardian’s signature)
(date)
________________________________________________________ ____________________________
(Teen Signature)
(date)
677 Lynnwood Dr. * Minerva, Ohio * 44657 * (330) 868-4101