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After Crew Registration
After Crew 23-24 School Year
Child's Information
Name
(Required)
Child’s First Name
Child’s Last Name
Child's Birthdate
(Required)
MM slash DD slash YYYY
Child's Grade
(Required)
Child's School
(Required)
Days Child Will Attend
(Required)
Monday
Tuesday
Wednesday
Thursday
Friday
Child's Start Date
(Required)
MM slash DD slash YYYY
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)
Check
Charge to my J account on file
Please contact me for payment information
Are you a member of the J?
(Required)
Yes
No
