Basketball
Fill out the form carefully to sign up each participant.
Class Date
January 5th, Thursday 4:00 to 5:00 PM
Class Date
January 9th, Monday 4:00 to 5:00 PM
Class Date
January 12th, Thursday 4:00 to 5:00 PM
Class Date
January 16th, closed for Martin Luther Day
Class Date
January 19th, Thursday 4:00 to 5:00 PM
Class Date
January 23rd Monday 4:00 to 5:00 PM
Class Date
January 26th, Thursday 4:00 to 5:00 PM
Class Date
January 30th, Monday 4:00 to 5:00 PM
Class Participant Name
*
First Name
Last Name
Gender
*
Male
Female
N/A
Age
*
Ethnicity
*
Hispanic/Latino
African American
Asian
White Caucasian
City where you live
*
Family/Parent/Guardian Name
*
First Name
Last Name
E-mail
*
Mobile Number
*
-
Area Code
Phone Number
Number in Household
*
Number over 62
*
My Products
*
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January Monthly Family Donation
$
25.00
Basketball
January Monthly Family Donation
$
35.00
Basketball
January Monthly Family Donation
$
50.00
Basketball
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