Jewish Community Center of Silicon Valley

JCC Service Desk
408.357.7429


	Ages 0-5

	Grades K-5

	Grades 6-12

	Adults

	Families

Registration Form - Adult

Complete this form to register for a JCC program or class...

Note: To register for a class using this online form, you must already have a credit card on file with the JCC. If you do not have a credit card on file with us, please print out the registration form and mail it or fax it. Click here for a printable registration form.

* Membership:

I am an APJCC member.
My membership number is...
Note: Your membership number is the number on your membership card that begins with the letter J.

I am a non-member.

* First Name:

* Last Name:

Birth Date:

Gender:

Male Female

* Address Line 1:

Address Line 2:

* City:

* State:

* Zip:

* Home Phone:

Cell Phone:

Work Phone:

* Email:

Program Choices
You can use this form to register for up to five programs.

* Program Title:
* Date & Time:
* Fee:

Program Title:
Date & Time:
Fee:

Program Title:
Date & Time:
Fee:

Program Title:
Date & Time:
Fee:

Program Title:
Date & Time:
Fee:

* Total Fees:

* Payment Info:

I am a JCC member and you have my credit card on file. You have my permission to charge my credit card.

* = required field

Payment Information...

If you are a Center Member and pay for your membership through automatic billing of your credit card each month, you have the option of paying online by selecting the “Charge my credit card on file” box above. If the JCC has your credit card on file for any other reason, you can also pay online. Make sure you've selected the "Charge my credit card on file" box above, and then press the "Submit Form" button below.
Please note: If you are signing up for a Fitness Department class (including fitness, group fitness, Pilates and aquatics classes), please read our refund policy.

If the JCC does not have your credit card on file, or if you would prefer to mail your payment, click the "Print Form" button to print this form. Then mail it with your check made payable to “APJCC”. You can also deliver your check and completed form to the JCC Service Desk. If you would prefer to pay by credit card, click here to print an application form that includes a section for your credit card information.
Please note: If you are signing up for a Fitness Department class (including fitness, group fitness, Pilates and aquatics classes), please read our refund policy.

Mailing address:
Addison-Penzak Jewish Community Center
14855 Oka Road, Suite 201
Los Gatos, CA 95032

Questions about how to register for a class?
Call the JCC Service Desk at 408.357.7429.