Please fill out ONE form for each child you are registering for Dolly Parton's Imagination Library. Children must be 5 years old and younger. Child's Name (First and Last) Child's Date of Birth (MM/DD/YYYY) Sex (Male or Female) Phone Number (xxx-xxx-xxxx) Email Authorized Adult's Name (First and Last) Authorized Adult's Address Street Address City State Zip code Mailing Address (if different) Street Address City State Zip Code How may we contact you? Phone Number Email Additional Questions Are you interested in signing up for Imagination Library after baby's birth? Yes No When do you expect baby? May we follow up with you after that time? Yes No Type Authorized Adult's Name CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit
