Gural JCC's Open Gym Program

Gural JCC's Open Gym Program

Registration Form
Participant Information
Participant's Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
School
Grade
Parent Information
Parent 1 Name

First NameLast Name
Parent 1 Email
example@example.com
Parent 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent 2 Name

First NameLast Name
Parent 2 Email
example@example.com
Parent 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Consent
Payment Information

Schedule of Classes:

	Boys Grades 6-8 45 min after Shabbat - 11pm	Girls Grades 6-8 11am - 12:30pm
April - May Session	April 18, April 25, May 2, May 9	April 19, April 26, May 3, May 17
May - June Session	May 23, May 30, June 6, June 13	May 24, May 31, June 7, June 14

Your $36 registration fee provides access to any or all of the 4 classes offered during the session that you register for. Participants may attend sessions designated for their registered group only.

Program Registration

JCC Sports & Fitness Sunday Open Gym for Girls (Grades 6-8) - April/May Session

$36.00

JCC Sports & Fitness Sunday Open Gym for Girls (Grades 6-8) - May/June Session

$36.00

JCC Sports & Fitness Saturday Night Open Gym for Boys (Grades 6-8) - April/May Session

$36.00

JCC Sports & Fitness Saturday Night Open Gym for Boys (Grades 6-8) - May/June Session

$36.00

Total

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Should be Empty:

Gural JCC's Open Gym Program

Participant Information

Parent Information

Payment Information

Program Registration*

Program Registration