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Fall 2012 Program Guide

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Programs and Activities at the Shimon and Sara Birnbaum Jewish Community Center in Bridgewater NJ
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Page 1: Fall 2012 Program Guide
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Dear JCC Family,

All of us at the JCC have always found this to be “the most wonderful time of the year”. It is the time when we can both reflect on what a wonderful summer season we have had and look forward to the upcoming year. Our Day Camp was home to more than 700 children/teens/counselors this summer. Each day was carefully planned to create a safe, meaningful and memorable summer. The swim club opened this summer with a beautiful new look. Families spent their days with us soaking up the sun and enjoying the activities. If you are not a lover of all things outdoors , you didn’t need to look any further… our summer was filled with Fitness classes, Mah Jongg Tournament, a 5K Race/Walk, Family Fun Nights, visits from an NBA superstar and so much more! Looking forward to the Fall is easy to do when there are so many exciting happenings. First on our schedule is a new event…Dog Day at the J on September 9. Dogs and their humans are all welcome to this outdoor event! On Sunday, September 23, we will be the installation of our new Pool Dome. Thanks to the generosity of many of our members, we will hold a community wide “Dome Raising” day beginning at 9 am. We NEED VOLUNTEERS comfortable with power tools to assist us. (Contact Carol at x215 if you would like to participate.) We are thrilled and excited by the opportunities that will open up with this new expansion. Our Blaustein Early Childhood Center and J-Crew After School Program are both ready for a new school year. Of course we have a full schedule of fitness and aquatics, a new season of Jewish LIFE and much more! Please take some time and read through this Program Guide… it is filled with fantastic offerings. Our Larry Cubas 3 vs 3 Basketball Tournament takes place on September 23. This event allows us to award two $1,000 scholarships to area high school seniors for their college education. Texas Hold’em Tournament on October 22, which is one of our many fundraisers that allow us to award scholarship assistance to our families in need. We are very exciting about our new Fundraising event Dancing with the JCC stars on December 1st. At this special event we will be honoring two couples in our community who have given so much to the JCC and our Jewish Community, Judy & Larry Gross and Shuey & Sid Horowitz. In addition we have 8 JCC stars who will competing for the coveted “Mirror Ball” trophy…David Bernstein, Marsha Chazin, Tom Flynn, Karen Kasnetz, Michael Klem, Adam Pearl, Shari Pollak and Betina Goldberg-Rappoport. We hope you will join us for this fun event. We are now accepting ads for our J Bill which accompanies this event. As you can clearly see our days are filled with exciting activities for youth, teen, adults, families. We realize you have options but when you add it all up no one can provide you and your family with so many quality choices. We are committed to making your experience as enjoyable and wonderful as we possibly can. The Staff and the Board wish you and your family a Happy and Sweet New Year! Shana Tovah in 5773.

Laura Friedman David BunevichInterim Executive Director President, JCC Board of Directors

PROFESSIONAL STAFF

Connie Adamo Assistant Bookkeeper – x209, [email protected]

Andrea BerkowFinance Director - x263, [email protected]

Paula ColemanAquatics Assistant- x230, [email protected]

Cindy ElgrablyGraphic Designer & Marketing Associate - x217,[email protected]

Jamie Fawcett Receptionist - x201, [email protected]

Laura Friedman Interim Executive Director - x213, [email protected]

Deby Goldberg Receptionist - x201, [email protected]

Debbie GoldenSpecial Projects Director/Marketing Director - x210

[email protected]

Carol Goldstein Administrative Assistant - x215, [email protected]

Susan Greenbaum Consulting Director - x212, [email protected]

Martha HaywardAccounting/Payroll & Camp Registrar - x209, [email protected]

Stacey Herman Family/Judaic Programming - x201, [email protected]

Stephanie Johnson Aquatics Director - x230, [email protected]

Ken KausAfter School Program Director and Web/Social Media Manager

x227, [email protected]

Jay KelloggAssistant Fitness Director - x225, [email protected]

Caryn KeninBabysitting Coordinator - x220

Lisa Kopman Adult/Senior Director - x206, [email protected]

Jamie Levin Tween Coordinator - x201, [email protected]

Ellen McCloskey Sunday Receptionist/Membership Associate - x201, [email protected]

Joy McIntyre Fitness Director - x226, [email protected]

Lauren Paniccia Assistant Camp Director - x264, [email protected]

Sarah Pollak Membership Director/Office Manager - x205, [email protected]

Daryl Regazzini Senior Program Assistant - x206

Jim Sala Swim Club Manager - x575, [email protected]

Elana Schwartz ECC Admin. Assistant - x266, [email protected]

Paige SilberfeinAssistant Executive Director/Camp Director - x207,

[email protected]

Joe SiragusaMembership and Personal Trainer - x275, [email protected]

Jinny StrawdermanAccounting/Billing - x234, [email protected]

Dawn VanNessDance School Instructor - [email protected]

Linda WeissEarly Childhood Director - x208, [email protected]

Robert WojciechowskiMaintenance Director - x224, [email protected]

Mike YearwoodSwim Team Director - x252, [email protected]

Peter Giraldi, Maribel Melendez, Joe Obenauer, Joe RoehrichMaintenance Staff

LETTER TO MEMBERS

IN MEMORY OF GENE ROSEN

Those of us who work at the JCC know that our center is what it is because of the people. We think of our JCC as a big family, and for many of us on staff, our fellow staff members are part of our extended family. Over the years, our staff has gone through a lot together...both the happy things in life and the sad. Losing our dear friend Gene has been the most difficult thing for us. We are so saddened by the loss of our beloved family member, Gene Rosen, who passed away in July after a long illness. Gene was a hero to all of us at the JCC. Besides being the ultimate gentleman and professional, he was an inspiration to all of us. It is hard for any of us to remember

when Gene became ill, because it truly never changed him.

Gene was the most positive person most of us have ever met. He loved the JCC… he loved working here and we loved that he was on our staff. He came to work every day with a smile on his face and with a positive attitude for each and every day. He cared about everyone very deeply... our staff and our JCC members.

All of us believe the JCC is a better place because of Gene. We greatly miss our friend, our family member, Gene Rosen.

WWW.SSBJCC.ORG FALL 2012 PROGRAM GUIDE 1

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AQUATICS

INFANT/TODDLER COURSES

Aquatots IAges 6 months - 18 months

A fun introduction to the water for infants beyond the bathtub! Songs and activities help to develop basic arm and leg movements as well as learning to be comfortable getting their faces and bodies wet. Water safety and fun is also stressed. A swim diaper and rubber pants are required under the child’s swimsuit.

Aquatots IIAges 18 months to 3 years old

For those little swimmers who are already comfortable in the water! Songs and activities help infants and toddlers further gain confidence and practice their budding basic swimming skills. Starfish skills are introduced and children begin to work more with the instructor to get prepared to move to the next level of swimming and rely less on Mommy and Daddy’s help. A swim diaper and rubber pants are required under a child’s swimsuit.

Little StarfishAges 2 and a half - 3 and a half

This course is for those little ones who can’t wait to put their faces in the water and splash around but aren’t quite ready to leave Mommy and Daddy and move onto Starfish. This course will teach all of the Starfish skills with the comfort of their parents or adult friend in the water to help them explore the fun world of the pool. Emphasis will be placed on transitioning toddlers from parents to instructor and gaining confidence with their independence in the water.

Proper Supervision...is more than the lifeguards’ responsibility:

Children ages 4 and younger MUST have an adult within arm’s length of them at all times. Children ages 7-11 are permitted in the pool provided that a parent remains in the pool area. Children ages 12 and up are permitted to be alone in the facility. Thank you for helping us keep our pools safe and secure.

Choosing the Right Swim Class/LevelIf you are unsure of a child’s level, you can bring your swimmer in to be tested or contact the Aquatics Director for questions. An in-person evaluation will ensure that your child will be in the correct class. It only takes a few minutes for an instructor to evaluate a swimmer’s level. Call the Aquatics office for more information or to schedule an appointment to start your swimmer off with the correct class this session.

Observation of LessonsWhile we recognize that parents are as thrilled about the progress of their children as the students are, we respectfully ask that parents remain seated on the 6 foot side of the pool bleachers for the duration of your child’s lesson. Unless specified (such as a parent/child swim class) parents are not permitted in the water with their children as this is a distraction to the group as a whole. Thank you for your cooperation.

Make Up PolicyGroup swim classes at the Bridgewater JCC enjoy a limited four student to one instructor ratio. Because of this ratio classes fill up quickly leaving not much option for a make-up class. In order to be considered for a make up class, a doctor’s note must be given to the Aquatics Office. The Aquatics Department cannot guarantee that a makeup class will be available, however every effort will be made to accommodate the need of the individual and that there is space in the class desired.

CODE # SESSIONS DAY TIME MEMBER FEE NON-MEM. FEE

52-101-F12 12 Sunday 8:45 - 9:15 AM $144 $288

52-201-F12 10 Monday 11:00 - 11:30 AM $120 $240

CODE # SESSIONS DAY TIME MEMBER FEE NON-MEM. FEE

52-102-F12 12 Sunday 9:30- 10:00 AM $144 $288

52-202-F12 10 Monday 11:30 AM - 12:00 PM $120 $240

52-210-F12 10 Monday 6:15-6:45 PM $120 240

CODE # SESSIONS DAY TIME MEMBER FEE NON-MEM. FEE

52-103-F12 12 Sunday 10:15 - 10:45 PM $144 $288

Stephanie Johnson Aquatics DirectorEmail: [email protected] x 230

Paula ColemanAssistant Aquatics DirectorEmail: [email protected] x 530

52-203-F12 10 Monday 12:00 - 12:30 PM $120 $240

52-211-F12 10 Monday 7:00 - 7:30 PM $120 $240

WWW.SSBJCC.ORG WINTER 2011 PROGRAM GUIDE 2121 FALL 2012 PROGRAM GUIDE

AQUATICS SESSION RUNS FROM

SEPTEMBER 15 - DECEMBER 13NO CLASSES NOVEMBER 22,24,25

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AQUATICSYOUTH COURSES Level 1Introduction to Water SkillsThere are no prerequisites for this level. The objectives of Level 1 are to learn basic personal water safety information and skills, to help participants feel comfortable in the water and to enjoy the water safely. In Level 1, participants learn elementary aquatic skills, which they will build on as they progress through the six Learn-to-Swim levels. At this level, participants begin developing good attitudes about swimming and water safety, good swimming habits and safe practices in and around the water.

Level 2Fundamental Aquatic SkillsParticipants entering this course must have a Level 1 certificate or must be able to demonstrate all the completion requirements in Level 1. The objective of Level 2 is to give participants success with fundamental skills. Participants learn to float without support and to recover to a vertical position. This level marks the beginning of true locomotion skills. Participants continue to explore simultaneous and alternating arm and leg actions on the front and back to lay the foundation for future strokes.

Level 3Stroke DevelopmentParticipants entering this course must have a Level 2 certificate or must be able to demonstrate all the completion requirements in Level 2. The objectives of Level 3 are for participants to learn the survival float, the elementary backstroke and to coordinate the front crawl. They are introduced to the scissors kick and the dolphin kick and build on the fundamentals of treading water. Participants also learn rules for headfirst entries and begin to learn to enter the water headfirst from the side of the pool. (if the water is 9 feet deep or deeper).

CODE # SESSIONS DAY TIMEMEMBER

FEENON-MEM.

FEE

52-007-F12 12 Saturday 1:00 -1:30 PM $144 $288

52-122-F12 12 Sunday 11:30 - 11:30 AM $144 $288

52-123-F12 12 Sunday 11:45 - 12:15 PM $144 $288

52-124-F12 12 Sunday 12:30 - 1:00 PM $144 $288

52-311-F12 10 Tuesday 4:00 - 4:30 PM $120 $240

52-405-F12 10 Wednesday 7:00 - 7:30 PM $120 $240

52-511-F12 9 Thursday 4:00 - 4:30 PM $108 $216

CODE # SESSIONS DAY TIMEMEMBER

FEENON-MEM.

FEE

52-008-F12 12 Saturday 1:00 -1:30 PM $144 $288

52-125-F12 12 Sunday 11:00 - 11:30 AM $144 $288

52-126-F12 12 Sunday 11:45 - 12:15 PM $144 $288

52-406-F12 10 Wednesday 6:15 - 6:45 PM $120 $240

52-512-F12 9 Thursday 4:45 - 5:15 PM $108 $216

CODE # SESSIONS DAY TIMEMEMBER

FEENON-MEM.

FEE

52-009-F12 12 Saturday 1:45 -2:15 PM $144 $288

52-127-F12 12 Sunday 10:15 - 10:45 AM $144 $288

52-128-F12 12 Sunday 11:00 - 11:30 AM $144 $288

52-129-F12 12 Sunday 11:45 - 12:15 PM $144 $288

52-130-F12 12 Sunday 12:30 - 1:00 PM $144 $288

52-131-F12 12 Sunday 1:45 -2:15 PM $144 $288

52-312-F12 10 Tuesday 5:30 -6:00 PM $120 $240

52-407-F12 10 Wednesday 5:30 -6:00 PM $120 $240

52-513-F12 9 Thursday 5:30 -6:00 PM $108 $216

CODE # SESSIONS DAY TIMEMEMBER

FEENON-MEM.

FEE

52-010-F12 12 Saturday 1:45 -2:15 PM $144 $288

52-132-F12 12 Sunday 10:15 - 10:45 AM $144 $288

52-133-F12 12 Sunday 11:00 - 11:30 AM $144 $288

52-134-F12 12 Sunday 11:45 - 12:15 PM $144 $288

52-135-F12 12 Sunday 12:30 - 1:00 PM $144 $288

52-313-F12 10 Tuesday 1:15 -1:45 PM $144 $288

52-408-F12 10 Wednesday 4:45 -5:15 PM $120 $240

52-514-F12 9 Thursday 6:15 -6:45 PM $120 $240

Level 4Stroke ImprovementParticipants entering this course must have a Level 3 certificate or must be able to demonstrate all the completion requirements in Level 3. The objectives of Level 4 are to develop confidence in the strokes learned thus far and to improve other aquatic skills. Participants improve their skills and increase their endurance by swimming familiar strokes (front crawl, elementary backstroke) for greater distances. Students also continue to build upon the scissors kick and dolphin kick by adding the arms for sidestroke and butterfly. The back crawl and the breaststroke are introduced in Level 4, as well as the basics of turning at a wall.

Level 5Stroke RefinementParticipants entering this course must have a Level 4 certificate or must be able to demonstrate all the course requirements in Level 4. The objectives of Level 5 are to coordinate and refine strokes. Participants refine their performance of all the strokes (front crawl, back crawl, butterfly, breaststroke, elementary backstroke and sidestroke) and increase their distances. Flip turns on the front and back are also introduced.

Level 6Personal Water SafetyParticipants entering this course must have a Level 5 certificate or must be able to demonstrate all the completion requirements in Level 5. The objectives of Level 6 are to allow for swimmers to be comfortable and confident in the water, while increasing their endurance and their stroke efficiency. Swimmers will perfect breaststroke and butterfly as well as continue building all strokes and endurance. Flip turns will be introduced and diving will be expanded to proficiency.

CODE # SESSIONS DAY TIMEMEMBER

FEENON-MEM.

FEE

52-011-S12 12 Saturday 2:30 - 3:00 PM $144 $288

52-136-S12 12 Sunday 12:30 - 1:00 PM $144 $288

52-137-S12 12 Sunday 1:15 - 1:45 PM $144 $288

52-409-S12 10 Wednesday 4:00 - 4:30 PM $144 $288

CODE # SESSIONS DAY TIMEMEMBER

FEENON-MEM.

FEE

52-012-S12 12 Saturday 2:30 - 3:00 PM $144 $288

52-138-S12 12 Sunday 12:30 - 1:00 PM $144 $288

52-139-S12 12 Sunday 1:15 - 1:45 PM $144 $288

52-314-S12 10 Tuesday 7:00 - 7:30 PM $120 $240

52-410-S12 10 Wednesday 4:45 -5:15 PM $120 $240

52-515-S12 9 Thursday 7:00 - 7:30 PM $108 $216

WWW.SSBJCC.ORG WINTER 2012 PROGRAM GUIDE 2323 FALL 2012 PROGRAM GUIDE SHIMON AND SARA BIRNBAUM JCC

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Course Materials All class fees include the costs of course materials such as books, pocket masks and certification cards. All materials are distributed on the first day of the class; however, you can have your materials sent to you prior to the start of the course for an additional fee of $15. If you would like this option, please indicate so at the time of registration. All materials must be returned UNMARKED in order to receive a full refund, otherwise you will be charged for the course materials.

Pretests Some American Red Cross courses such as the Lifeguard Training and WSI courses, require a pretest as part of the course. These pretests typically take place the first scheduled day of the course. Students should check with the Aquatics office to find out the exact time and location of their pretest. Please remember this pretest is MANDATORY and failure to attend will result in a failure of the course with NO refund.

Proof of Age The American Red Cross mandates that candidates show valid proof of age by the second class meeting for those courses that have minimum age requirements. We are not permitted to waive the minimum age requirements for any of our training courses.

Certification/Completion of Course Although our goal as instructors is to help students successfully complete their certification goals, students are sometimes not able to adequately complete the stated requirements for the course. Payment of the course fee and participation in class does not guarantee certification; students must successfully complete all course objectives in order to be certified.

If you and/or your child have questions or concerns regarding your/their ability to pass this course, please contact the Aquatics Department PRIOR to registering.

Lifeguard Training Full CourseLifeguard Training Full Course(r.12)

The purpose of this course is to provide entry-level lifeguard participants with the knowledge and skills to prevent, recognize and respond to aquatic emergencies and to provide care for breathing and cardiac emergencies, injuries and sudden illnesses until emergency medical services (EMS) personnel take over.

Pre-requisites for the course

•Mustbe15yearsoldonorbeforethefinalscheduledsessionofthecourse.

•Swim300yardscontinuouslydemonstratingbreathcontrolandrhythmicbreathing.Candidates may swim using the front crawl breaststroke or a combination of both but swimming on the back or side is not allowed. Swim goggles may be used.

•Treadwaterfor2minutesusingonlythelegs.Candidatesshouldplacetheirhandsunderthearmpits.

•Completeatimedeventwithin1minute,40seconds.Startinginthewaterswim20yards.Thefacemay be in or out of the water. Swim goggles are not allowed. Surface dive, feet first or head first to a depth of 6-10 feet to retrieve a 10 pound object. Return to the surface and swim 20 yards on the back to return to the starting point with both hands holding the Object and keeping the face at or near the surface so they are able to get a breath. Candidates should not swim the distance under water. Exit the water without using a ladder or stairs.

After successful completion of the course an American Red Cross certificate for

Lifeguarding/First Aid/CPR/AED will be issued. These certifications are valid for 2 years. CODE DAY TIME MEMBER FEE NON-MEM. FEE

52-901-F12 Sundays October 7- 28 12:00 - 6:00 PM $275 $350

52-902-F12 Wed.- Mon. 12/26- 28, 12/31 9:00 - 3:00 PM $275 $350

Lifeguard Training Review CourseThis course allows a lifeguard to review written and physical skills for Lifeguard Training and CPR/AED for the Professional Rescuer with an American Red Cross Instructor prior to taking the written and practical portions of the Lifeguard Training recertification test. Prerequisites for review: Must possess current American Red Cross Lifeguard Training, CPR/AED for Lifeguards, and First Aid certifications. Successfully complete all the practical skills of lifeguard training test and score 80 percent better on all written sections. Must bring pocket mask and valid ARC Lifeguard certification cards to the challenge.

CODE DAY TIME MEMBER FEE NON-MEM. FEE

52-903-F12 Sundays, 10/21 and 10/28 12:00 - 6:00 PM $200 $275

52-904-F12 Friday, 12/28 & Mon. 12/31 9:00 - 3:00 PM $200 $275

AQUATICS TRAINING SCHOOL

CODE DAY TIME MEMBER FEE NON-MEM. FEE

52-909-F12 Wedsnesday, 10/17 2:30 - 4:30 PM $40 $60

52-910-F12 Monday, 11/19 5:30 - 7:30 PM $40 $60

52-911-F12 Tuesday, 12/4 2:30 - 4:30 PM $40 $60

CPR/AED/FA For LifeguardsThis course allows for lifeguards to challenge written and physical skills for CPR/AED for Lifeguards. This satisfies the American Red Cross requirement that lifeguards must renew their CPR/AED certifications 2 year from their initial date of certification. Must bring pocket mask and book to the challenge course.

24 WINTER 2012 PROGRAM GUIDE SHIMON AND SARA BIRNBAUM JEWISH COMMUNITY CENTER24 FALL 2012 PROGRAM GUIDE SHIMON AND SARA BIRNBAUM JCC

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GENERAL INFORMATION

The JCC is a “Kosher-Sensitive” FacilityKosher Sensitive is defined as:• No mixing of meat and dairy products.

• No eating of meat products with dairy at the same meal (if meat is served, no dairy can be served and vice versa).

• No pork or shellfish products.

• Food served at all SSBJCC programs and meetings, both on site and off site, shall be either dairy, meat (kosher) or pareve (containing neither meat nor dairy) only. There shall be no mixing of milk and meat.

• Members and non-members will be allowed to bring in food from the outside for their own consumption.

• As a courtesy to the wide variety of Jewish practices, no shellfish or pork may be brought on site, and members and non-members must refrain from the mixing of meat and dairy in any context.

Code Of Conduct• All participants should recognize that the Shimon and Sara Birnbaum

Jewish Community Center is dedicated to the welfare of all participants. In order to maintain a comfortable and safe environment, the management of the JCC asks that all of the participants at this facility:

• Refrain from the use of foul language, abusive actions or inappropriate behavior.

• Recognize that sportsmanlike conduct, fair play and a cooperative attitude govern behavior at all times.

• The J reserves the right to suspend membership privileges, without refund, of any member who:

• Aids in the unauthorized entrance of non-members.

• Becomes physically or verbally abusive to other members or staff.

• Disregards posted rules and regulations.

Make-Up PolicyNo make-ups, credits or refunds will be given to individuals missing classes due to illness or personal reasons.

Class Refund PoliciesThe JCC reserves the right to cancel any class or program if attendance or registration does not meet class quota. Full program fee will be returned to those people who have paid. A refund will not be given unless the class is canceled by the JCC. A credit minus a $15 processing charge will be given if written notification is received prior to the first class meeting.

Inclement WeatherIn the event of a change in JCC operating hours due to inclement weather, please listen for announcements on WCTC-AM 1450 and WMGQ-FM (Magic 98.3). You can also check your e-mail, check the JCC website: www.ssbjcc.org (Check the Home Page and/or click on “Calendar”) or call the front desk at (908) 725-6994 x201 for a recorded announcement.

Youth Policies• Children ages 12 and older who are JCC

members may enjoy the pool or gymnasium without direct adult supervision WHILE A PARENT IS IN THE BUILDING.

• All children under age 12 must be directly supervised by an adult (18 or older).

• You must be 13 and older to use the Fitness Center.

• Teens under 18 years must have parents sign a waiver & consent form in order to use the Fitness Center.

• Teens 13-15 must be accompanied by a parent in order to use the Fitness Center.

• Children 10 or younger must pass a swim test in order to swim in the deep end of the pool.

• Children wearing bubbles or belts are not permitted in the deep end of the pool.

• Lap lanes are available for swimmers who are AGE 10 OR OLDER.

ValuablesThe JCC is not responsible for lost or stolen articles in the locker room, gym, pool, etc. Please use the “valuables lockers” outside the fitness center or bring a lock to secure your locker while you are in the building. Locks must be removed after each use to allow other members to use the locker, except for Patrons and Benefactors with “Reserved” lockers.

Financial AssistanceThe Jewish Community Center recognizes the need to serve all of those in the community regardless of financial ability. In order to provide our services to everyone, we offer financial assistance for program fees and membership dues to those who qualify. To receive information on financial assistance that may be available to you, please call 908.725.6994 x213.

Program RegistrationJCC membership in good standing throughout the length of the program is required for member registration. You may register for most programs in person, by mail or by fax. In order to provide the best program quality to our members, it is sometimes necessary to limit the number of participants in a class. Registration will close when that limit is reached. Members receive priority over non-members.

WWW.SSBJCC.ORG FALL 2012 PROGRAM GUIDE 27

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REGISTRATIONREGISTER EARLY

Classes are filled on a first-come, first-served basis. Classes may be cancelled if there is insufficient registration. Please register no later than one week prior to class or program start date.

Let us help you register...In person or over the phone. Call or visit the JCC Front Office:8:30 AM - 8:30 PM (Monday-Thursday), 8:30 AM - 4:30 PM (Fridays) and 9:00 AM - 5:00 PM (Sundays).

Front Desk: (908) 725-6994 x201

Please PRINT All InformationBe Sure To List Class By CODE # and NameAre you a JCC member? Yes No Today’s Date ______________________

Participant’s Name ____________________________________________________________________________________ Male Female

Parent’s Name if under 18 _____________________________________________________________________________

Address/City/Zip _____________________________________________________________________________________

Phone (Work) _________________________________ (Home) _________________________________ (Cell) _________________________________

E-mail ___________________________________________________________ Date of Birth ______________________

Grade & school, if child _______________________________________________________________________________

Total Amount: $ ______________ Check #______________ Cash Charge Visa MC Amex

Name On Card _________________________________________________________

Cardholder Signature __________________________________________________

Address Of Cardholder _________________________________________________

Phone # Of Cardholder _________________________________________________

Cred. Cd. Acct. _________________________________________________________

Expiration Date ________ / _________

Full payment is due at the time of registration. Please include charge information when registering by fax, (908) 725-9753

If a participant withdraws from a class or activity before the session has begun, a full refund is made. After the first class, a prorated refund plus a $5 processing fee will be charged (this applies to each class). No refunds are made after the second class.

ALL WITHDRAWAL AND REFUND REQUESTS MUST BE MADE IN WRITING.

Amount Enclosed Course Number Course Name Participant First Name Participant Last Name Date of Birth

1.

2.

3.

4.

5.

Send Completed Form To: JCC775 Talamini RoadBridgewater, NJ 08807Attn: Class Registration

28 WINTER 2012 PROGRAM GUIDE SHIMON AND SARA BIRNBAUM JEWISH COMMUNITY CENTER28 SUMMER 2012 PROGRAM GUIDE

Ellen McCloskeySunday Receptionist,

[email protected]

Jamie Fawcett Daytime Receptionist, [email protected]

Deby GoldbergSaturday & Evening Receptionist,

[email protected]

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