Reflex Recreation Center(勵健体育会) PS 105 Basketball Class Registration Form
This is form is for new students to register for Reflex Recreation Center 🏀 SATURDAY basketball training classes at PS 105. After you fill out the registration form, our staff will follow up with you within a week. Welcome students age 7 -16.

Location
PS105小學
1031 59th St, Brooklyn, NY 11219
 Indoor Gymnasium

Date
04/27/2024 - 06/22/2024
4/27, 5/4, 5/11, 5/18, 6/1, 6/8, 6/15, 6/22
(Total 8 classes )

No Class
5/25

Time
SATURDAY
10:00 am - 11:30 am (age 7-9)
11:40 am - 01:10 pm (age 10-12)
01:20 pm - 02:50 pm (age 13-15)

Fee 
$280 / 8 Classes 
- No make-up classes except for medical reason ( need doctor's note)

Visit the following page for class information
http://www.reflexrecreation.org/index.php?s=/Home/Custom/show/cid/12.html
Spots are limited. First come, first serve. Seat is not reserved until payment is made in full.

👉 Class Preparation Memo 上課準備及須知 ⬇️
https://drive.google.com/file/d/1zc0CkF6O6M55gX1vlrCVMpoW1MDHo3KD/view?usp=drive_link


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Last Name *
Student' s information
First Name *
Student' s information
Email  *
Address *
Gender *
School Name *
Date of Birth *
MM
/
DD
/
YYYY
Age *
Select the training season *
Class Selection
Basketball Classes at PS 105 offer on Saturday only, Please select one class only. 
Visit the following page for class time for each age group.
10:00am – 11:30am (age7-9)
11:40am – 1:10pm (age 10-12)
1:20pm – 2:50pm (age 13-15)

10:00am – 11:30am
11:40am – 1:10pm
1:20pm – 2:50pm
SATURDAY
Clear selection
Parent/Guardian 1 - First Name *
Parent/Guardian 1 - Last Name *
Parent/Guardian 1 - Relationship *
Parent/Guardian 1 - Phone Number *
Parent/Guardian 2 - First Name
Parent/Guardian 2 - Last Name
Parent/Guardian 2 - Relationship
Parent/Guardian 2 - Phone Number
Emergency Contact Information 1 - First Name *
Alternate Pickup/Release
Emergency Contact Information 1 - Last Name *
Emergency Contact Information 1 -  Relationship *
Emergency Contact Information 1 -  Phone Number *
Does your child have any known health conditions that would make them unsuitable for participating in rigorous physical activities, training, or gym class?
 *
Considering both physical and mental conditions. 
Is there any remark / special instruction you would like to share regarding your child's health conditions?
Does your child have any allergy? *
Required
If YES, Please Explain the allergy
Submit
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