BETHESDA-CHEVY CHASE JEWISH COMMUNITY GROUP 6125 Montrose Road ~ Rockville, MD 20852 ~ 301-348-3763 Sunday School (Judaics) Registration Form If you are a JCC member, please provide the following information My JCC membership expires on this date: _____________ My JCC membership number is: ___________________ Name Grade Hebrew ___________________________________________ ______ _______ ___________________________________________ ______ _______ ___________________________________________ ______ _______ Fees: First child in Sunday School Each additional child BCC-JCG Family Membership dues (Not applicable if you are a JCC member): $650 $550 $110 Sunday School Dues $ ________________ BCC-JCG Family Membership Dues (Not applicable if you are a JCC member) $ ________________ Tax Deductible Donations $ ________________ Book / Activity Fee ($60 per student—Judaics program only) $ ________________ $75 Late Registration Fee for registrations received after 7/10/2014 $ ________________ Installment Fee ($50 if payment is not made in full by 9/14) $ ________________ SUBTOTAL: $ ________________ Less early registration discount for Judaics Program $ ________________ (subtract $50 for first child and $25 per child after the first if registered with full payment by 6/30/2014) BALANCE DUE: $ ________________ NOTES: 1. Payment Schedule (if not paying in full by 9/14/2013 – there is a one time $50 fee for paying in installments): 1/3 of total due by July 10, 2014 1/3 of total due by October 30, 2014 Balance due by December 30, 2014 2. $50 discount for first child and $25 per child after the first if registered with full payment by 6/30/2014 3. All accounts need to be paid IN FULL by December 30, 2014 4. An additional 1.5% per month will be added to unpaid balances effective December 30. 2014. Members are responsible for all collection and legal fees. Send your payment, made payable to BCC-JCG, with forms to: BCC-JCG ~ 6125 Montrose Road ~ Rockville, MD 20852 ~ Attn: Registration I have read and acknowledge the complete tuition, fee schedule, and terms and conditions of membership with the BCCJCG for the 2014-2015 school year. Parent Signature: ________________________________________________________________________________ Permissions: Please circle YES or NO for the following: YES NO I give permission for my child to be photographed and allow BCC-JCG to use pictures on the BCC-JCG web site. YES NO I give my permission for my child to participate in all activities on or around the grounds of the JCCGW campus, including Ring and Landow Houses. Please turn over and fill out additional membership information. 6 Information for BCC-JCG Membership List: Father’s Information Mother’s Information Guardian’s Information Name Mailing Address (City, State, and Zip Code) Home Phone Number Work Phone Number Cell Phone Number E-Mail Address My child’s Bar/Bat Mitzvah date is: ___________________ Please indicate below any information that you do not want included in the BCC-JCG directory (this directory is only distributed to BCC-JCG members) ___ Home Address __ Email __ Home Number __ Work Number __ Cell Phone Children Not in Sunday School (with ages): Name(s): ___________________________________________________________ Age(s): ______________ Name(s): ___________________________________________________________ Age(s): ______________ Name(s): ___________________________________________________________ Age(s): ______________ The best way to get information to me is. Please check two. e-mail ___ mail ____ flyers _____ web site _____ phone ____ Please indicate how you heard about the BCC-JCG. __ Center Scene __ Yellow Pages __ Jewish Week __ Flyer _____________________ other (indicate source) Please indicate your willingness/interest in assisting with the following special activities: (check at least two activities) __ Room Parent (Grade(s)___) __ Telephone Caller __ Board Member __ Substitute teacher __ Staff Appreciation __ Chanukah Party __ High Holy Day Services __ Advertising __ Classroom Aide __ Torah Rental __ Friday Night Oneg __ Saturday Night Havdallah __ Weekend-in-Woods/Retreat __ Newsletter __ Brochure/Articles __ Chaperone/Driver for Class Trips __ Art Projects __ Flyers __ Bulletin Board __ JCC Chanukah Festival __ JCC Purim Festival __ Silent Auction/Fund Raiser __ Plant Sale __ Community Service Projects (e.g., blood drive) __ Other activities, interests or special knowledge/talents that you would be willing to share with the children such as cooking, art projects, folk dancing, music, religious practices _______________________________________________________________________________________________ _______________________________________________________________________________________________ Please indicate your willingness/interest to be a co-chair for the following committees/sub-committee: __ Budget __ Advertising/Marketing __ Room Parents __ Board Member __ Communications __ High Holidays/Religious __ Silent Auction Special Events: __ Holiday Parties/Potlucks __ Friday Night Onegs __ Weekend-in-Woods/Retreat Indicate your interest in the following Open Executive Board positions: __ Vice President __ Corresponding Secretary __ Newsletter Editor 7
© Copyright 2024 ExpyDoc
