JungleGym For NYCHA Family Days Application

NYCHA Tenants' Associations in East Harlem, let's partner to bring JungleGym to your Family Day.

First Name

Last Name

Address

Email

Phone

State/Province

Date(s) our TA would like to host Family Day:

NYCHA Development:

Estimated # of residents that live in the development:

Estimated # of residents that will attend this event:

Location of Family Day (exact blocks, if on a street, or open spaces if within the development):

Resources I have already secured:

I have submitted a permit request for this event:

Yes

No

Unsure

I have submitted a sound permit for this event:

Yes

No

Unsure

Names and roles of people responsible for organizing Family Day:

The best time to reach me is:

Morning

Afternoon

Evening

Any time

Application does not guarantee acceptance. Concrete Safaris will contact you to discuss details.