Literacy Happens at CORA

Parent Name*

First Last

Child #1 Name*

First

Child #2 Name

First

Child #3 Name

First

Email

Address

City

State

Zip Code

Phone

Do we have your permission to photograph you and/or your child during activities?*

YES, I authorize CORA Services, Inc. to use a photograph taken of me and/or the undersigned minor children listed, in any and all publications, including but not limited to all CORA Services printed and digital publication.
NO, I do not authorize photography to be taken during the events.

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