Jump Kids Double Dutch Team
2025/26
Location
*
Essex/Union County Resident
Burlington County Resident
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Child's info
Name of athlete (First, middle, last)
*
Date of Birth
*
-
Month
-
Day
Year
Date
Age
*
Gender
*
Female
Male
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Parent Info
Parent/Gardian Name
*
Address
*
City
*
State
*
Zip
*
Cell Phone
Emergency Phone
*
Emergency Contact Name
*
Please list any allergies/medical conditions below:
*
Does your child have health insurance?
Yes
No
If so, what carrier?
*
Policy #
Parent/Guardian eSignature (First & Last Name)
*
Today's Date
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Month
-
Day
Year
Date
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My Products
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Team Registration
$
55.00
Quantity
1
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10
Winter Uniform Fee
$
100.00
Quantity
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10
MonthlyTuition
$
150.00
Quantity
1
2
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7
8
9
10
Spring/Summer Uniform Fee
$
150.00
Quantity
1
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9
10
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