JCC After Camp Sports Application


Player Information

First Name
Last Name
Date of Birth
Age
School
Other School Name
Camp
Other Camp Name
Grade entering this September
Does your child have any allergies or medical conditions?
Which league (After Camp) will you be registering for?
Register for Second Boys After Camp and Save 100
Register for Third Boys After Camp and Save 200
Total Payment
 Please note that we will consider putting your child with a suggested friend but cannot guarantee that he/she will be on the same team.
 Makeups TBD
Shorts Size
Shirt Size

Parent Information

Mother's Name
Mother's Phone
Mother's Email
Father's Name
Father's Phone
Father's Email

Emergency Contact Info

Emergency Contact #1 Name
Emergency Contact #1 Phone
Emergency Contact #2 Name
Emergency Contact #2 Phone

Conditions of Enrollment

LIABILITY/MEDICAL

Having been informed of the activities to be conducted, I as a parent or guardian of the child, assume all risks and hazards incidental to the activities and release from responsibility and agree to indemnify and hold harmless the JCC, their officers, directors, independent contractors, volunteers, coaches, assistant coaches and all employees for any illness or injury to me or my children or family members during his/her/our participation.

Participation in these activities constitutes my/our permission to use any of the photographs of the participant for promotional purposes.

All registrations are final. No refunds, credits or transfers to other programs or people.

The JCC reserves the right to suspend or expel players that do not comply with the Rules and staff

In the event of an emergency I authorize the JCC to secure from any licensed hospital, physician or medical personal any treatment deemed necessary for me or my child’s immediate care and agree that I will be responsible for payment of any and all medical services rendered. I understand that this authorization includes transporting my child by ambulance if necessary to the nearest medical treatment facility if I am unable to be reached first. I will not lay claims of liability or take legal action against the JCC and it’s staff.

 Check this box to agree to Conditions of Enrollment

Payment Information

Please Note: All Sales are Final

First Name
Last Name
Address
City
State
Zip
Payment Method
Card Type
Card Owners Name
Card Number
CVV
Expiration Date
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