Junior Deputy Academy Leave this field empty Cadet Information First Name This field is required Middle Name Last Name This field is required Street Address This field is required City This field is required ST This field is required Zipcode This field is required Home Phone 706-555-1212 This field is required Invalid Format Date of Birth 04/28/2024 This field is required Invalid Format Name of School This field is required T-Shirt Size S M L XL T-Shirt Size Adult Youth Parent/Guardian Information First Name This field is required Last Name This field is required Email Address example@example.com This field is required Invalid Format Address This field is required City This field is required ST This field is required Zipcode This field is required Work Phone 706-555-1212 Invalid Format Cell Phone 706-555-1212 Invalid Format Emergency Contact (other than parents) First Name This field is required Last Name This field is required Relationship This field is required Phone Number 706-555-1212 This field is required Invalid Format Street Address City ST Zipcode Doctor's Name This field is required Phone Number 706-555-1212 This field is required Invalid Format Street Address City ST Zipcode Allergies Physical Limitations Invalid Format Cadet is to be picked up at 5:00 p.m. each day (please do not pick your child up early or pick then up late). List any person who has your permission to pick up your child other than the parent(s)/guardian(s) listed previously. Name Phone Number 706-555-1212 Invalid Format Name Phone Number 706-555-1212 Invalid Format Name Phone Number 706-555-1212 Invalid Format If my child is selected, he/she will attend the Junion Deputy Academy. To the best of my knowledge, all the above information is correct. Parent/Guardian This field is required Parent/Guardian Signature Clear This field is required Date 04/28/2024 This field is required Invalid Format SPECIAL NOTE: Cadets are NOT to be using and/or playing with cell phones at any time during Junior Deputy Academy. Continue