Membership Form 2021 JCC Membership Special Now through January 2021 - $21 activation fee plus receive $50 in "J" Bucks and a complimentary orientation session with a personal trainer! ("J" Bucks can be redeemed towards future JCC programming registrations or additional guest passes) To finalize your membership, payment will be taken over the phone or in person.How would you like to pay?*PAY MONTHLYPAY IN FULL *Pay in full and commit to a year of membership by 12/31/20 and lock in 2020 rate for 12 mths. Receive an additional $50 in J BucksProduct NameMembership Category (Pay In Full)*Choose one of the following...Young Adult (Age 13-30) $588.00Individual (Age 31-69) $864.00Couple (2 Adults at same residence) $1,344.00Family (2 Adults and Dependents under age 25 at the same residence) $1,548.00Single Parent Family (Unmarried parent with dependent children under age 25 at same residence) $1,152.00Senior Individual (Age 70+) $768.00Senior Couple (2 spouses with 1 or both at age 70+) $1,116.00Membership Category (Pay Monthly)*Choose one of the following...Young Adult (Age 13-30) $49.00Individual (Age 31-69) $72.00Couple (2 Adults at same residence) $112.00Family (2 Adults and Dependents under age 25 at the same residence) $129.00Single Parent Family (Unmarried parent with dependent children under age 25 at same residence) $96.00Senior Individual (Age 70+) $64.00Senior Couple (2 spouses with 1 or both at age 70+) $93.00JCC Membership Contract 2021Primary MemberName* First Middle Last Gender*MaleFemaleOtherBirth date* Date Format: MM slash DD slash YYYY Cell Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Occupation* Occupation Place of Employment Work PhoneE-mail Address* Emergency Contact* First Last Emergency Contact Phone*Relationship with Emergency Contact*Household StatusMarriedSingleDivorcedWidowedHow did you hear about the JCC?* Website/Social Media Direct Mail Family/Friend Referral Do you own a wearable fitness tracker?*YesNoInterests:* Fitness Floor/Weights/Cardio Group Exercise Aquatics Youth Programs After-school programs Dance Yoga Early Childhood Summer Camp Team Sports Active Older Adult Programs Child Development Center Secondary MemberName First Middle Last GenderMaleFemaleOtherBirth date Date Format: MM slash DD slash YYYY Cell PhoneOccupation Occupation Place of Employment Work Phone E-mail Address DependentsName First Last Birth Date Date Format: MM slash DD slash YYYY Name First Last Birth Date Date Format: MM slash DD slash YYYY Name First Last Birth Date Date Format: MM slash DD slash YYYY Name First Last Birth Date Date Format: MM slash DD slash YYYY Name First Last Birth Date Date Format: MM slash DD slash YYYY Terms & ConditionsMembership Contract* I accept terms and conditions. Code of Conduct*The JCC reserves the right to amend or add additional policies to the JCC Member Code of Conduct. I accept code of conduct. DisclaimerCompleting the online membership contract is step 1 of joining the Staenberg Omaha JCC. The Membership isn’t active until payment is received. If payment isn’t received by the time the promotion has ended, then the contract & promotion will be void. To finalize your membership, payment will be taken over the phone or in person. If you have any questions or are ready to make a payment, call Member Services at 402-334-6426.
