2021-2022 JCCNS School Year Registration
Fill out this form to register your child(ren) for the JCCNS school year.
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Parent/Guardian Information
Parent/Guardian Name *
Primary Phone Number *
Primary Email Address *
Additional Parent/Guardian Name
Additional Phone Number
Additional Email Address  
Address of Residence   *
Student Information
Child's name *
Child's Date of Birth *
List and describe any allergies that affect your child. *
Does your child have any health or developmental issues we should be aware of? *
What is your child's reaction to new situations/people? *
Has your child had previous preschool or daycare experience? *
Is your child potty-trained? *
Emergency Contact Information
Emergency Contact   *
Emergency Contact's Phone Number(s) *
Authorized Pick-up
Please list names of individuals who are allowed to pick up your child from school other than parents (such as grandparents, babysitters, etc.)
Student Registration Information
Registration Type *
Please Check the box(es) of the Morning Sessions (8:30am-12pm) for which you would like to enroll your child (any questions please contact registrar@jccnursery.org). If a morning session is unavailable, please select the waitlist if you are still interested in having your child attend that day. *
Required
Please Check the box(es) of the Afternoon Sessions (12pm-2pm) for which you would like to enroll your child. If an afternoon session is unavailable, please select the waitlist if you are still interested in having your child attend that day. *
Required
Would you be interested in enrolling for additional afternoons if they were offered? Which ones?
Are there any younger siblings that would be interested in attending the JCC when eligible? If so, please list their name(s) and birth date(s).
Are you interested in receiving more info about our summer camp program?
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How did you hear about the JCCNS? *
Parent Contract
https://drive.google.com/file/d/18k-CQzJhWVjmg3v_OkbsPxgTpq2E2b4L/view?usp=sharing
By typing my name in the space provided, I understand that I agree to the terms and conditions laid out in the JCCNS Parent Contract  (follow the link above). *
You've reached the end of the form. We will be in touch shortly to confirm your registration. Your child's space is not reserved until we receive your registration fee ($0 for Brit Shalom Members, $40 before March 1, 2021, and $60 March 1, 2021 and after). Please mail a check made out to JCCNS of State College to 620 E. Hamilton Ave. State College, PA 16801. For current families, you're welcome to complete this payment via Google Pay.
The Jewish Community Center Nursery School of State College, Inc.  is a 501(c)(3) and admits students of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school.
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