Register for Kings County Tennis League's 2019 Winter Tennis Program at Ingersoll!
WHAT:
A free, weekly tennis program every Saturday for children ages 5 - 10

WHERE:
- Ingersoll Community Center (177 Myrtle Ave)

WHEN:
- Saturday mornings, 10:30 AM - 12:30 PM, beginning January 5 until March 23

OTHER:
*There will be at least one field trip
**Tennis equipment provided

Email address *
Student's First Name *
Your answer
Student's Last Name *
Your answer
Gender *
Please select one
Student's Date of Birth *
MM
/
DD
/
YYYY
Parent/Guardian Name *
Your answer
Parent/Guardian Email Address *
Your answer
Are you interested in joining a committee of parents led by our Program Manager? *
Street Address *
Ex.123 Main Street, Apt 15
Your answer
Parent/Guardian Primary Phone Number *
(123) 456-7890
Your answer
Parent Guardian Secondary Phone Number
(987) 654-3210
Your answer
Do you and/or your child live in Ingersoll Houses? *
If "No," do you and/or your child live in a NYCHA housing development other than Ingersoll?
If "Yes," to the above, provide the name of the development here.
Your answer
What school does your student attend? *
Your answer
Which category describes your annual household income? *
How many members are a part of your household? *
Child's Race/Ethnicity *
Emergency Contact Name *
This should be someone other than the parent/guardian listed previously.
Your answer
Emergency Contact Phone Number *
(123) 456-7890
Your answer
Emergency Contact's Relationship to Student *
Your answer
Does the student have any food allergies? *
If yes, what food is your child allergic to?
(If no, leave blank)
Your answer
Are there any other medical conditions you think we need to be aware of?
Your answer
Uniform Size *
How did you hear about us? *
If you selected "Other" above, please explain.
Your answer
Please check the box below to signify your agreement with the KCTL Student Release Form and Liability Waiver: https://drive.google.com/file/d/0B0Vuk8XcPJqqUjBtSnhXZE1CdUE/view *
Required
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