Robert E. Loup Jewish Community Center
JCC Maccabi 2011 Athlete/Artist Registration Join Team Denver for an unbelievable JCC Maccabi Experience! Denver will send a delegation to each of this summers hosts: Israel, Philadelphia and Springfield. Teens may choose to compete in Israel or in the US. Please note the specific sports teams traveling to the US cities has not yet been determined. Athletes must turn 13 by July 31, 2011. NAME: ______________________________________________________________________________________ DATE OF BIRTH (DOB): _____________________ ADDRESS: ____________________________________________________________________________________________________________________________ CITY: _____________________________________________________________________________ STATE: ___________________ ZIP: ____________________ ATHLETE/ARTIST EMAIL: ________________________________________________________________________________________________________________ HOME PHONE: _____________________________________________ ATHLETE/ARTIST CELL PHONE: ________________________________________________ SCHOOL: ________________________________________________________ SYNAGOGUE: ________________________________________________________
PARENT’S NAME: ______________________________________________________________________________________________________________________ HOME PHONE: _________________________________________________ CELL PHONE: ___________________________________________________________ PARENT’S EMAIL: _____________________________________________________________________________________________________________________
How did you hear about the Game? ____________________________________________________________________________________________________ Please rank the top three sports in the location that you would like to compete in from the list below by numbering 1—3. One sport must be an individual sport.
Israel Games & Artsfest
Philadelphia/Springfield*
July 24—August 5, 2011 Ages 14—17 (as of July 31 2011) Fee: $3,500
August 14—19 Ages 14—16 (as of July 31, 2011) Fee: $,1600
TEAM SPORTS: ❑ Basketball ❑ Soccer ❑ Bowling ❑ Tennis ❑ Swimming ❑ Table Tennis ❑ Volleyball
ART SPECIALTIES: ❑ Acting/Improv ❑ Culinary Arts ❑ Dance ❑ Broadcast Journalism ❑ Visual Arts ❑ Jazz/Rock/Vocal Music
SPORTS: ❑ Girls Soccer ❑ Boys Baseball ❑ Girls Volleyball ❑ Boys & Girls Basketball ❑ Golf ❑ In-line Hockey ❑ Track and Field ❑ Lacrosse ❑ Table Tennis ❑ Soccer ❑ Bowling *Games locations will be determined based on results from team tryouts and ❑ Dance national allowment. ❑ Swimming ❑ Tennis
For more information please contact our Team Denver delegation heads Jamie Skog at (303) 316-6391 or jskog@jccdenver.org Yuri Tavbin at 303-316-6304 or ytavbin@jccdenver.org 350 South Dahlia Street • Denver, CO 80246 • (303) 316-6349 • www.jccdenver.org