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2. 
3. YCPL Teen Programs Participant
   Agreement and Code of Conduct

5. Teens will be supervised for the duration of each event, but the library is not responsible for teens who leave before, during or after the program has ended. Teens must be picked up within 15 minutes of the program’s conclusion.

7. Teen Code of Conduct Agreement

   As a participant in a YCPL Teen Program, I agree to respect the library, my fellow program participants, and library staff. I will follow staff instructions and agree to abide by library rules. My parent/legal guardian and I both understand that if there are any issues, library staff may contact my parent/guardian to pick me up at any time during the event. Inappropriate conduct includes, but is not limited to:

   • Threatening, offensive or abusive language and behavior
   • Harassment or disrespect of employees or other participants
   • Misuse or defacement of library facility or materials
   • Violating any state, federal or local laws
   • Violating terms of use for computers
   • Underage drinking and illegal substance use
9. Teen Name*
10. Age*
12. Grade in Spring 2023*
    -- Select One --6th7th8th9th10th11th12th
14. Medical Issues

    List any allergies, medications needed, etc. for the teen that library staff need to be aware of in the box above.

16. By typing my name below, I hereby agree to the Teen Code of Conduct.

18. Teen Signature*
19. Date*
    Date

21. By typing my name below, I hereby give permission to the child listed above to attend and participate in teen programs at the York County Public Library. I understand that my child will be under adult supervision within the library for the duration of the program.

23. Parent Name*
24. Phone*
26. Parent Signature*
27. Date*
    Date
29. Transportation Authorizations

    ** If this information changes, it is the responsibility of the parent/guardian to notify library staff and complete a new permission form. **

31. Teen Transportation

    1. My child has permission to drive themselves to and from the Library for Teen Programs.

    Check this box if teen has permission to drive themselves.

33. Adult authorized to pick up teen:*

    Name & Phone

35. Second adult authorized to pick up teen

    Name & Phone

Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field