Outdoor Pool Summer 2022 Registration

1 Start 2 Rates 3 Payment 4 Terms 5 Complete

Gear up for Summer 2022 at the Outdoor Pool!

Family Information

Your First Name *

Your Last Name *

Your Email *

Best Phone *

What number should we use to contact you with any questions?

JCC History *

Have you, or your family, ever participated in JCC Greater Boston programs, such as: Membership, Outdoor Pool, Camp Grossman, Camp Kaleidoscope, Early Learning Centers, Aquatics, etc.?

Address

Your Date of Birth *

Year

Month

Day

Your Gender

Street *

City *

State *

5 Digit Zip *

5 Digit Zip, part 1

Family Members

Are there additional people in your family? Select all that apply:

Second Adult

Children

Second Adult

Please complete if there is another adult in the family.

First Name *

Last Name *

Date of Birth *

Year

Month

Day

Gender

Number of Children *

How many children are in your family?

Child 1

First Name *

Last Name (if different) *

Date of Birth *

Year

Month

Day

Gender

Child 2

First Name *

Last Name (if different) *

Date of Birth *

Year

Month

Day

Gender

Child 3

First Name *

Last Name (if different) *

Date of Birth *

Year

Month

Day

Gender

Child 4

First Name *

Last Name (if different) *

Date of Birth *

Year

Month

Day

Gender

Child 5

First Name *

Last Name (if different) *

Date of Birth *

Year

Month

Day

Gender

Child 6

First Name *

Last Name (if different) *

Date of Birth *

Year

Month

Day

Gender

Emergency Contact Name *

Emergency Contact Phone *

Leave this field blank

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Gear up for Summer 2022 at the Outdoor Pool!

Family Information