Secure Registration All information entered is protected by the latest and most secure encryption methods available. JCC Member: Yes  No Parent Name: Place of Employment: Child's Name: Age: -- 3 4 5 6 7 8 9 10 11 12 13 Birth Date: -- Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec -- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 ---- 1994 1995 1996 1997 1998 1999 2000 2001 2002200320042005 Address: City: State: Zip: Telephone: Email:  Emergency Contact: Emergency Phone: Comments:    Spring Clinics April 14 - May 23   Intro to Baseball (3 yrs) Weds, 2:30-3:15PM or Fri 4-4:45PM Apr 16/18 - May 21/23 Members-$80, Non-$100         Intro to Baseball (4 yrs) Thurs, 2:30-3:15PM or Fri, 4-4:45PM Apr 17/18- May 22/23 Members-$80, Non-$100         Pee Wee (5 yrs) Mon & Weds, 4:00-5:30PM Apr 14-May 21 Members-$140, Non-$170         Rookies (6 & 7 yrs) Mon & Weds, 4:00-5:45PM Apr 14-May 21 Members-$140, Non-$170         Prospects (8 & 9 yrs) Tues & Thurs, 4:00-5:45PM Apr 15-May 22 Members-$140, Non-$170         Majors (10 - 13 yrs) Tues & Thurs, 4:00-5:45PM Apr 15-May 22 Members-$140, Non-$170         2008 Spring Break Camp, Ages 5-13 Free pre and post camp supervision, 7:30AM - 6:00PM Full Day Camp includes lunch and snack each day. Half Day, Members-$100, Non-members-$140 Full Day, Members-$190, Non-members-$210   Half Day Full Day Mar 31-Apr 4 2008 Summer Camp, June 11-Aug 15 Free pre and post camp supervision, 7:30AM - 6:00PM Full Day Camp includes lunch and snack each day. Half Day, Members-$100, Non-members-$140 PER WEEK Full Day, Members-$190, Non-members-$210 PER WEEK   Campers can come one or two weeks, whatever fits their schedule. Half Day Full Day Pre Season, Jun 11-13 Session 1, Jun 16-27 Session 2, Jun 30-Jul 11 Session 3, Jul 14-25 Session 4, Jul 28-Aug 8 Session 5, Aug 11-15 Payment Options    Credit Card: ---- Visa Master Card Credit Card #: Expiration: -- 01 02 03 04 05 06 07 08 09 10 11 12 ---- 2005 2006 2007 2008 2009201020112012 Name on Card:   I hereby voluntarily submit my child's/my application for attendance and participation in Danny Berry's JCC Baseball League and assume full responsibility for any and all damages, injuries, or losses that my child/I may sustain or occur while attending or participating, and hereby waive all claims against the Dave and Mary Alper JCC or anyone associated with this event.      This form is secured by 2048-bit encryption

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