Library Card Application – Under 18

New Card Application

Any resident of the Jefferson County Rural Library District or the City of Port Townsend is eligible to get a library card. Visitors may be issued a library card with limited privileges. Minors under 18 years of age may receive a library card with a parent or guardian signature.

Name*
First Middle Last
Birthdate:*
MM slash DD slash YYYY
Residential Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Mailing Address (If different from Residential)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Enter Email Confirm Email
Receive hold notices by*
- Email
- Text
- Phone
Untitled
The Library Periodically sends email notifications about upcoming programs and events.
- Receive notices about upcoming programs and events
- I do NOT want to receive notices about upcoming programs and events
You can manage library subscriptions here: https://jclibrary.info/news-letter-opt-in/
FOR MINORS:
Please print the names of parents of guardians who will be responsible for this account:*
Parents/guardians, please choose ONE for your child under 18, when at the Jefferson County or Port Townsend Public Libraries:
- Full Access Card
- NO Public Computer Use (materials checkout only)
- Public Computer Use ONLY (no materials checkout)
SIGNATURE(S):
I agree to assume full responsibility for all materials checked out to me or my dependents, to promptly pay charges for lost or damaged materials, and to give immediate notice if my card is lost or my address changes. I understand that failure to comply with public library policies may result in loss of borrowing privileges. Parents/guardians are responsible for their children’s selection and checkout of library materials. I also agree to abide by the library’s Internet Acceptable Use Policy when using the library’s computers and/or wireless internet access. Parents/guardians are responsible for monitoring their children’s computer and Internet use at the Library.
Adult (18 and over) or parent e-signature.

Person who signs here will need to show ID when at the library and picking up the card.
CAPTCHA
Name
This field is for validation purposes and should be left unchanged.

New Card Application

FOR MINORS:

SIGNATURE(S):