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Super Sports 2024

REGISTRATION FOR SUPER SPORTS IS NOW OPEN FOR BOYS GRADES 1-4.  PLEASE COMPLETE A SEPARATE FORM FOR EACH CHILD BY FRIDAY, MARCH 22ND. PLEASE COMPLETE THIS FORM AND REMIT PAYMENT.

PROGRAM WILL TAKE PLACE FROM 2:30 -4PM EACH FRIDAY BEGINNING FRIDAY APRIL 5TH

PARENTS INFORMATION

EMERGENCY CONTACT INFORMATION
In the event of an emergency, we will attempt to contact a parent by phone at the numbers provided above. Please also provide the names and phone numbers of two additional emergency contacts to be used if we are unable to make contact using the numbers above. Additionally, please provide the names and numbers of your pediatrician and dentist.
In the box above, please note any important medical information concerning your child’s medical history, including allergies, medications being taken or any other information to which a physician or emergency medical personnel should be alerted.

PLAYER INFORMATION

I authorize my children to participate in regular and ongoing youth programs at and with the Young Israel of Jamaica Estates and to participate in all trips and athletic leagues to which I give my written consent. I understand that in the event of a medical or other emergency, YIJE personnel will attempt to contact me and/or authorize emergency treatment as described above. I will not hold the Young Israel of Jamaica Estates, its members, officers or employees responsible for any such medical emergency or treatment thereof.

I further understand that my child will not be permitted to participate in this or any program until the above consent is submitted in writing.

Please enter full name of parent that completed this form
Sat, April 27 2024 19 Nisan 5784