Wednesday, September 8, 2010

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JCA Membership Application

The Jewish Community Alliance is a membership organization. Its primary purpose is to provide programs through which Jewish identification and physical, social and emotional development of the individual may take place. JCA membership is open to all who understand and support its purposes.

Membership in Name of

Select :

First Name :

Middle Name :

Last Name :

Sex :

Male
Female

Birthdate :

Address :

City :

State :

Zip code :

Business Name :

Occupation :

Home Phone :

Business Phone :

Business Extension :

Cellphone :

Emergency Name :

Emergency Phone :

E-mail Address :

Non-Jewish
Jewish

Congregation Affiliation :

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Spouse

Select :

First Name :

Middle Name :

Last Name :

Sex :

Male
Female

Birthdate :

Business Name :

Occupation :

Business Phone :

Business Extension :

Cellphone :

E-mail Address :

Non-Jewish
Jewish

Congregation Affiliation :

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Dependent children (23 years old & younger)

Name :

Sex :

Male
Female

Birthdate :

E-mail Address :

School :

Name :

Sex :

Male
Female

Birthdate :

E-mail Address :

School :

Additional Children :

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I/We are interested in (check all that apply):

Fitness Program	Personal Training
Group Exercise Classes	Water Aerobics
Swim Lessons	Swim Team
Recreational Swimming	Tennis Lessons
Tennis Team	Recreational Tennis
Fitness Equipment	Racquetball
Adult Basketball	Youth Basketball
Sports Clinics/Leagues	Summer Camps
Aerobics Classes	Youth Camps
Preschool/Kindergarten	Preschool Enrichment Classes
Mommy & Me	AfterSchool Care
Break Away Days (vacation care)	Youth Theatre
Cultural Arts	Social Activities

I/We heard about the JCA through (check all that apply):

Local Television	Local Radio
Local Newspaper	JCA Mailer
JCA Website

Doctor :

I was referred by :

JCA Member :

I was referred by :

I/we are applying for membership at the JCA for use of its facilities, subject to the rules and regulations established for the JCA by it Board of Directors.

I/we have read and understand the following:

A registration fee is required for all those applying for membership. This fee is not applied to dues.

Membership is for a minimum of 12 months. Dues are to be either paid in full at the time of joining or extended payment plans may be arranged using automatic debit from checking accounts or automatic charges on your Visa or MasterCard. Membership will remain in effect unless I/we notify the JCA in writing with 30 days notice after the initial 12 months.

Membership fees are not transferable or refundable.

Membership services may be modified by the JCA.

Membership may be suspended or revoked if an individual does not comply with policies, rules and practices of JCA.

JCA reserves the right to raise dues as necessary.

After we receive your online application, we will contact you to make an appointment for you to sign the application and make payment arrangements.

JCA Calendar

Upcoming Events

Rosh Hashanah - JCA closes at 5 p.m.

Date: September 8, 2010

Rosh Hashanah - JCA closed

Date: September 9, 2010

Rosh Hashanah - JCA closed

Date: September 10, 2010

Time: 12:00 am

Tennis - Men’s Night

Date: September 14, 2010

Time: 6:30 pm - 7:30 pm