Borrower Registration

First Name	*
Middle Name
Last Name	*
Suffix
Email Address
Language	*
Date of Birth	*
Phone	*
Phone Type	*

Primary Address
Street	*
City	*
State	*
Zipcode	*

Statement of Responsibility I agree to observe all rules established by the Lexington Public Library and will be responsible for all material(s) borrowed on my card. I also agree to pay any fines or other charges imposed for late, lost, or damaged Library materials.
By submitting this form and as the authorized user, I accept responsibility for all materials checked out with this card.

*Required