Athlete's First Name
*
Athlete's Last Name
*
Gender
*
Male
Female
Other
Home Phone
*
Address
*
City
*
State
*
Zip
*
Teen's Date of Birth
*
Teen's Age as of July 31, 2022
*
Teen’s Cell Number
*
Teen’s Email
*
Parent 1 Name (First and Last)
*
Parent 1 Cell
*
Parent 1 Email
*
Parent 2 Name (First and Last)
Parent 2 Cell
Parent 2 Email
School your teen is attending as of Fall 2022
*
Do you speak any other languages other than English
*
Yes
No
If yes, please list them:
Does your teen speak any other languages other than English?
*
Yes
No
Please list them:
Sports 1st Choice
*
Sports 2nd Choice
Emergency Contact (other than parent) Name
*
Emergency Contact (other than parent) Phone
*
How did you hear about the JCC Maccabi Games®?
*
Has your teen participated in JCC Maccabi with the Mandel JCC of the Palm Beaches?
*
Yes
No
Please list any other JCCs the athlete is a member of or has participated in JCC Maccabi with (if applicable).
*
David Posnack JCC
Boca Raton (Levis)
North Miami Beach (Michael Ann Russell)
Miami Beach
South Miami (Dave and Mary Alper)
Sunrise (Soref)
N/A
Has your teen tried out for another JCC this year?
*
Yes
No
Which one?
Acknowledgement
I hereby declare that the information provided is true and correct.
Parent Name
First Name
Last Name
Teen Name
First Name
Last Name
Parent Signature
*
Submit
Should be Empty: