Child's Name *

First Name

Last Name

Parent's Name

First Name

Last Name

Phone *

(###)

###

####

Do you have a HRA/ACS Voucher? *

All childcare voucher accepted

I would like to use my ACS or HRA Voucher

I don't have any voucher

Does your child attend school at PS 289 (900 St Marks Ave)? *

Yes-FREE

No-$100 per month

Select Activity *

Activity is on 9:00 AM - 11:00 AM

Dance

Drums

Basketball

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from Brooklyn United. Message frequency varies. Message & data rates may apply. Text HELP to (347)-264-4069 for assistance. You can reply STOP to unsubscribe at any time. *

Yes

No