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. 1 Start 2 Complete Child's Name (First and Last) * Child's Date of Birth (MM/DD/YYYY) * Sex (Male or Female) * Phone Number (xxx-xxx-xxxx) * 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 Are you interested in learning about the parenting resources offered through the United Way of Central Georgia's First Steps service? * Yes No Resources offered are in the areas of health, education, and financial stability and include things like how to find the best childcare, how to find a good doctor for yourself and your child etc. How may we contact you? Please provide at least one form of contact. Phone Number Email Additional Questions Prenatal families are not yet eligible for Dolly Parton Imagination Library, but may be eligible for First Steps. Please answer these 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 * Submit
