JCC Family Programs Registration

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JCC Family Programs Registration

Use this form to Register for our Family Programs Classes & Events.

Family Programs Registration

Step 1 of 3 – Parent/Caregiver Information

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Parent Name*

First
Last
Parent Phone
Email*

Enter Email
Confirm Email
Parent 2 Name (if Applicable)

First
Last
Parent 2 Phone (if applicable)
Address

Street Address
Address Line 2
City
State / Province / Region
Zip / Postal Code

Country
Nanny/Caregiver Name (if applicable)

First
Last
Nanny/Caregiver Phone (if applicable)

Choose how many children you will be registering for Family Programs Classes or Events, then fill out details for each child.
Number of Children You are Registering

Choose how many children you are registering for a Family Programs class or event. You can enter different classes and events for different children.
Parent-Only Class or Program

You have selected to register 0 children. Please indicate the parent-only class or program you are registering for, or select how many children you are registering.
Child 1 Name

First
Last
Child 1 Date of Birth
Child 1 Class/Event Name, Day & Times

Enter the name of the class/event you want to register this child for. Also, please indicate the day and time of the class or program so we can ensure accurate registration, as we offer many variations of programs.
Child 2 Name

First
Last
Child 2 Date of Birth
Child 2 Class/Event Name, Day & Times

Enter the name of the class/event you want to register this child for. Also, please indicate the day and time of the class or program so we can ensure accurate registration, as we offer many variations of programs.
Child 3 Name

First
Last
Child 3 Date of Birth
Child 3 Class/Event Name, Day & Times

Enter the name of the class/event you want to register this child for. Also, please indicate the day and time of the class or program so we can ensure accurate registration, as we offer many variations of programs.
Child 4 Name

First
Last
Child 4 Date of Birth
Child 4 Class/Event Name, Day & Times

Enter the name of the class/event you want to register this child for. Also, please indicate the day and time of the class or program so we can ensure accurate registration, as we offer many variations of programs.
Child 5 Name

First
Last
Child 5 Date of Birth
Child 5 Class/Event Name, Day & Times

Enter the name of the class/event you want to register this child for. Also, please indicate the day and time of the class or program so we can ensure accurate registration, as we offer many variations of programs.
Child 6 Name

First
Last
Child 6 Date of Birth
Child 6 Class/Event Name, Day & Times

Enter the name of the class/event you want to register this child for. Also, please indicate the day and time of the class or program so we can ensure accurate registration, as we offer many variations of programs.

Do you or anyone in your immediate family consider yourselves Jewish?
- Yes
- No
My family is already an Annual Member of the JCC
I want to find out more information about becoming a member of the JCC.
- Yes
- No
The JCC offers programs for newborns through seniors. With programs for every age, we have something for everyone!
Comments

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