Jurupa Mountains Cultural Center
(Please print out this form and mail to the address below.)
Registration Form
Child's Name________________________________________________
Address____________________________________________________
City________________________________State________ZIP_________
Phone Numbers: Work__________________Home___________________
Age:________________________Grade:____________
Session#
I___II___III___IV___V___One child per registration form.
Please call for details and current information prior to sending in this
form.
Your registration will NOT be complete or confirmed until
all emergency cards are signed and your registration fee has been paid.
SEND TO:
Jurupa Mountains Cultural Center7621 Granite Hill Drive
Riverside, Ca. 92509
Phone: (951) 685-5818-Fax: (951) 685-1240Email: jmccmail@hotmail.com
Web: www.the-jmcc.org or www.jmcc.us
or