Be Added to the Waitlist

This form is for 2022-2023 After Crew. This is a waitlist to fill any additional spots available.

The application for 2023-2024 will be available soon.

After Crew

Child's Information

Name(Required)

Child's First Name Child's Last Name

Child's Birthdate(Required)

Child's Grade(Required)

Child's School(Required)

Days Child Will Attend(Required)

Monday

Tuesday

Wednesday

Thursday

Friday

Child's Start Date(Required)

Change of Days Policy(Required)

I understand that days may only be changed at the end of each month with permission from the director. Permission will only be given if room on the After Crew bus allows. The days indicated above are the only days that my child may attend the After Crew program.

Legal Guardian Information

Name(Required)

Legal Guardian #1 First Name Legal Guardian #1 Last Name

Legal Guardian #1 Email(Required)

Legal Guardian #1 Phone Number(Required)

Name

Legal Guardian #2 First Name Legal Guardian #2 Last Name

Legal Guardian #2 Email

Legal Guardian #2 Phone Number

Authorized Pick Up Information

Name

Authorized Pick Up #1 First Name Authorized Pick Up #1 Last Name

Authorized Pick Up #1 Email

Authorized Pick Up #1 Phone Number

Name

Authorized Pick Up #2 First Name Authorized Pick Up #2 Last Name

Authorized Pick Up #2 Email

Authorized Pick Up #2 Phone Number

Name

Authorized Pick Up #3 First Name Authorized Pick Up #3 Last Name

Authorized Pick Up #3 Email

Authorized Pick Up #3 Phone Number

Are there any specific person(s) to whom your child should NOT be released?

Photo Release Agreement

Photo Release Agreement(Required)

I understand that by participating in programs, classes, and/or by using the facilities of the Mayerson JCC, I give permission to the JCC to use my photograph or other likeness, or a photograph or other likeness of my spouse or partner or any of my children, in JCC publicity and/or marketing materials. If I choose not to allow the JCC to use such photography, I agree to provide the JCC with written notice of specific exclusions, at least 30 days before such exclusions will become effective.

Payment Information

How do you prefer to be billed for the After Crew fees?(Required)

Are you a member of the J?(Required)