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ONE BROOKLYN HEALTH- Injury Prevention Workshop Sign-in form
Virtual Safety presentation, for the community to stay safe in a variety of scenarios. Only Ten Participants per class
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Full Name
*
Your answer
Email
*
Your answer
Phone number
*
Your answer
Age Group
*
Below 12 yrs old
13 - 17 yrs old
18 - 26 yrs old
27 - 35 yrs old
36 - 45 yrs old
46 - 54 yrs old
55 - 64 yrs old
Above 65 + yrs old
Other:
Which training are you going to?
*
Tue 3/15, 3 - 4:15 pm
Re-register later for a different month
Will you invite other people to join these workshops?
*
Yes
No
Maybe
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