Register Your Child


Guardian Name *
Guardian Name
Phone *
Phone
How did you hear about Amped Up? *
Child Info
Name 1
Name 1
Gender
*Grade completed by summer 2018
Child 2 Info
Name 2
Name 2
Gender
Grade Completed
Child 3 Info
Name 3
Name 3
Gender
Child 4 Info
Name 4
Name 4
Gender
We will be offering shuttle services to and from the following stops.