Teen Center Registration Form

Select Your Program(s)

Some programs require parental approval to participate. These are marked with a (p!).

If you want to participate in programs marked with a (p!) the parent or guardian information is required.

Name *

First

Last

Name is required.

Email *

Email

Confirm Email

Name and email address are required. You may use your own email or your parent’s email address to register. If using your parent’s email address please make sure they are aware of it first.

Parental Consent Information

Some programs require consent to participate. If you selected a program that requires consent then please have them complete the section below. This is only for programs that are marked with a (p!) or if you are under 13 years old.

Name of Parent or Guardian

First

Last

Phone # of Parent or Guardian

Email of Parent or Guardian if Different from above.

*Note to Parents:

We strive to provide a safe and engaging environment for your kids. We can do this so much better if we have your input.

Please consider joining our TeenCenter group email list and/or Discord Channel. You can share your thoughts with other parents of Teens and Tweens who use the library as well as the Library staff directly involved with the Teen Center. Join the discussion and stay informed of events and happenings at the Belleville Public Library’s Teen Center.

Additional Information

Do you have a question or suggestion? Would you like to start your own group in the Teen Center? Tell us what is on your mind.