Membership Application Submission- JCC Buffalo

Billing Address

Home Address

Emergency Contact Information

Credit card information:

I authorize the Buffalo JCC to initiate transactions to my credit card account and by the method indicated above. I authorize the credit card institution to charge my account, for the amount indicated, on the 1st day of each month. I understand that the JCC will notify me, in advance, of any change in the monthly fee charged to my account due to any change in the fees for my membership or for new services added by my consent. 

eCheck information:

I authorize the Buffalo Jewish Community Center to prepare and execute a bank draft or EFT in the amount and by the method indicated above. I authorize my banking institution to debit my account for the amount indicated. I understand and agree that if I close my account or stop payment on my bank draft or EFT that I will be obligated to pay the balance of my fees immediately. If for any reason my draft should not be honored, I will be responsible for that draft amount plus a $25 service charge. I understand that my account will be drafted on the 1st day of each month. I understand that the Buffalo JCC will notify me in advance of any change in the monthly fee charged to my account due to any change in fees for my membership or for new services added by my consent.

Total:  

You will not be charged until your application is approved.

IMPORTANT INFORMATION: Please read carefully and check the box indicating your understanding.

I/we understand that our membership is perpetual and that at any time the JCC may adjust my/our membership fee.  If it does, then the JCC will provide me/us with 30 days written notice.

If my/our bank or credit card issuer does not honor my/our EFT or charge, then I/we will be responsible for full payment plus the service charge applied by the JCC as noted above.

I/we will notify the JCC if I/we change my/our bank or credit card before my scheduled payment is to be withdrawn.

Membership dues and registration fees are non-refundable and non-transferable.  

I/we can cancel my/our membership at any time by giving 30 days written notice to the JCC. I understand that rejoining requires a registration fee.

I/we will complete fully and truthfully any medical screening forms which may be required as a condition for participation in any JCC program.

I/we will use all JCC facilities and participate in all JCC activities at my/our sole and exclusive risk and I/we assume full responsibility for all injuries that I/we may sustain. I/We waive all claims for damage, loss or theft of property arising out of or in connection with the use of all JCC facilities (including the parking lots). 

I/We for myself/ourselves and my/our estate(s) hereby release and hold harmless the JCC and its officers, directors, and employees from all damages, claims, loss and/or liability relating to my/our death or all injuries which may arise from my/our participation in JCC programs.

While using the JCC facilities my/our photograph may be taken and used for publicity purposes.

I/we understand that if I/we need to replace our key fob(s), I/we will be charged $10 per fob.

I/we will comply with all of the JCC rules.  Membership at the JCC is a privilege which can be revoked.

The JCC reserves the right to change facilities, hours, class schedules and equipment, and  promises to provide all of its members with reasonable notice of all changes.

I/We give consent to receive notice of impending annual meetings and hereby agree to accept