Imagination Library Registration Form 2023

Dolly Parton’s Imagination Library is dedicated to inspiring a love of reading by gifting books free of charge to children from birth to age five, through funding shared by Dolly Parton and local community partners.

If you're a Southside Housing Association tenant and have a child aged 0-5 years old please submit your details below to receive a free book each month, starting from September 2023.

Please note, applications for children above 5 years old will not be processed.

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* 1. Child Information 1:

1st Child's FULL Name: *

Child's Home Address: *

City:

ZIP/Postal Code: *

Date of Birth: *

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* 2. Child Information 2:

2nd Child's FULL Name:

Child's Home Address:

City:

ZIP/Postal Code:

Date of Birth:

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* 3. Parent/carer Information:

Authorised Adult Name:

Email Address:

Phone Number:

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* 4. Consent:
“I hereby explicitly consent to allow the Dollywood Foundation, Inc. to use the information provided herein for the purpose of participation in Dolly Parton’s Imagination Library book gifting programme. To measure the benefits of this program we may cerate datasets with the information provided herein and share them with research and educational advancement partners. You agree to review our full Terms & conditions and Privacy Policy by visiting https://imaginationlibrary.com/. By ticking the box and submitting this form you expressly consent to the terms set forth herein.”

Yes I Consent