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Printable Version:

Download Registration Form

Interested in a Payment Plan?

Call (570) 824-4646

Medical Release Form

Once you’ve completed your application, please download a PDF of our Medical Form below and print. Please Return to JCC, 60 South River Street, Wilkes-Barre, PA 18702

Download Medical Release Form

If you’d like to request a mailed application, do so via the below:



Register Online

Credit card payments are accepted securely through Stripe.

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