Spring JR Wilcox after school program

Little Hoopers Tuesday, Wednesdays, Thursdays 3:30-4:30

Tuesdays JK-grade 1 Wednesdays grade 2-grade 4 Thursday Soccer grade 1-3 - 10 weeks - March 28th - May 30th 2023
Athlete Information
Child's Name*

First NameLast Name
Guardian / Parents Names*

First NameLast Name
Guardian Cell Phone number

Area CodePhone Number
E-mail*
Teachers name and room number
Does your child attend the daycare after program?

yesno
Which session are you registering for?*

September 17-November 5th (Saturdays 8 weeks)November 12- January 14 (Saturdays 8 weeks)
Which session*

Tuesday Basketball JK-Grade 1Wednesday Basketball Grades 2-4Thursday Soccer Grades 1-3
Emergency Contact & Health Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Health Card Number / Card Date
Does your child have any allergies, chronic illness, or medical conditions that would limit high level activtiy?*

YesNo
Please describe*
Parental Permission For Emergency Treatment In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to: I give consent for the facility to secure any and all necessary emergency medical care for my child.
Release of Liability I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against Little Hoopers and the persons in charge.
I have read and agree to the above conditions*

YesNo
Confirmation E-mail*
Signature*

Clear
Important Notes

· Fee: $200 + HST which is a total of $226.00 per participant for 10 weeks. You can send an email transfer to torontogauchos@gmail.com. In the message please indicating your childs name. We will send welcome email 1 week before the session begins. If you need subsidy or payment schedule please let us know via email littlehooperstoronto@gmail.com

Pick up:

The session will begin at 3:30-4:30.

Please pick up your child at the main doors at 4:30. If your child attends the after school program please let them know your child will be in our program.

Also please inform your childs teacher that they will be doing this program.

Thank you!
Which time slot?*

10:00-11:00am beginner11:00am-12:00pm intermediate12:00pm-1:00pm advanced
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Little Hoopers Tuesday, Wednesdays, Thursdays 3:30-4:30