Imagination Library Registration - First Nations Health Consortium

Dolly Parton Imagine Library Registration Form

Only Indigenous (Frist Nations, Inuit, Metis) Children in Alberta can be registered.

Status

Are you indigenous?

Yes

No

What Nation are you from?

Child Information

Childs Name (1)

First Name

Last Name

Childs Date of Birth

Childs Name (2)

First Name

Last Name

Childs Date of Birth (2)

Address

City

State/Province

Zip/Postal

Country

Caretaker Information

Authorized Adult Name

First Name

Last Name

Phone

Email

“I hereby explicitly consent to allow the Dollywood Foundation, Inc. to use the information provided herein for the purposes of participating in Dolly Parton’s Imagination Library book gifting program. To measure the benefits of this program we may create 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 imaginationlibrary.com. By signing and submitting this form you expressly consent to the terms set forth herein.”

Authorization

Yes, I do

Would you like to be added to our mail list for updates on events and programs?

Yes, please add me

If you are human, leave this field blank.

Return to Dolly Parton’s Imagine Library Main Page

Dolly Parton Imagine Library Registration Form

Status

Child Information

Caretaker Information

We are thankful for Canadian Natural Resources ongoing support for the Dolly Parton Imagination Library.

Your generous donation is greatly appreciated!