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JUP YOUTH I-PAD CHECK IN
Get a jumpstart on registering yourself or your youth.
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* Indicates required question
Name (first & last)
*
Your answer
Birthday
*
MM
/
DD
/
YYYY
Youth Phone # (if applicable)
Your answer
Home Address
*
Your answer
Allergies?
*
Your answer
Medical Concerns?
Your answer
Grade
*
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
What School Do You Attend?
*
Your answer
PARENT SECTION
Having parent information is super helpful. There is space for 2 parents; however, only 1 is required. Please fill out as much as you would like.
Parent1: Name (first & last)
*
Your answer
Parent 1: Email
*
Your answer
Parent 1: Phone Number
*
Your answer
Parent 2: Name (first & last)
Your answer
Parent 2: Email
Your answer
Parent 2: Phone Number
Your answer
PICTURE PLEASE
A face pic is needed to complete the registration. This picture will be on the check in screen in order to tap it and check in. Pics can be emailed or sent as a text to Kelly: 561-309-5588 or bkbetz@hotmail.com.
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