GTGC Summer Basketball Clinic

Name: GTGC Summer Basketball Clinic
Start: 2023-07-01T08:30:00-04:00
End: 2023-09-30T12:30:00-04:00
Location: Good Tidings

July 1 @ 8:30 am - September 30 @ 12:30 pm

Free Basketball Clinic for kids 7-17 each Saturday mornings from 8:30 am- 12:30 pm (Dates: July 1st to September 30th). Breakfast and Lunch will be served @ the church. Safety is top property so please arrange for someone to pickup your child at 12:30 pm at the church. If you need assistance please speak to Good Tidings Staff.

Parent/Guardian Email *

Child's Name *

First

Last

Child's date of birth *

Home Address *

If between grades, list the grade the Scout will be in at the start of the next school year.

Home Email Address *

Primary Emergency Contact Name *

First

Last

Primary Emergency Contact Number

Relationship *

Secondary Emergency Contact Name *

First

Last

Secondary Emergency Contact Number

Secondary Emergency Contact Relationship *

Please list any food allergies *

Does your child have asthma? *

Any health concerns or condition we should know about? *

Does your child have a Individualized Education Plan *

Yes
No
Other

If yes, is there anything we should know or consider?

If Other, what is your child's Education Plan?

Safety is our number priority. However, in case of an emergency do we have your permission to take your child to the hospital. *

Child's Insurance Name *

Child's Insurance Policy Number *

Please provide proof (picture/image) of your child's health insurance to gtgc@gtgc.goodtidingsbrooklyn.org

Agreement *

I agree

In consideration for your accepting this entry, I the undersigned as the parent/guardian will comply and will instruct my child(ren) to comply with all the rules and regulations governing Good Tidings Gospel Chapel. I do further agree that a licensed medical doctor will verify his /her physical condition prior to their participation in the GT Basketball Clinic.

By printing your name you are signing this application *

To submit in-person visit GTGC Sundays 12:30-1:30pm:

PRINT BLANK APPLICATION (Optional)

Details

Start:: July 1 @ 8:30 am
End:: September 30 @ 12:30 pm

Venue

: Good Tidings
: 345 Malcolm X Blvd
BROOKLYN, NY 11233 United States + Google Map
Phone: 718-467-5037
: View Venue Website