JUDA Registration

Select the option that applies *

Annual membership - $ 695.00

Fall Session Fee - $ 232.00

Winter Session Fee - $ 232.00

Spring Session Fee - $ 232.00

I have already Signed up for the year - $ 0.00

Total Amount

Your information

First Name *

Last Name *

Email Address *

Phone *

Please be sure to write your FULL street address and apartment number if applicable

Street Address *

City (Primary) *

State (Primary) *

Postal Code (Primary) *

Your Children's Information. Name(s) - English & Hebrew Gender, Date of Birth *

Authorize.net (Credit Card)

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *