Shield Up: Youth Self-Defense Registration – Male Ages 14-17 years | 2:15pm-3:15pm JIY Shield Up: Youth Self-Defense Registration Ages 14-17 years | 2:15pm-3:15pm Your DetailsFull Name* First Last Participant or Parent's Phone Number*Participant or Parent's Email* Date of Birth* Month Day Year Age*Please enter a number from 14 to 17.Do you have any allergies?*YesNoIf yes, please describe your allergies.Emergency ContactEmergency Contact Name* First Last Emergency Contact Phone Number*JIY – Shield Up: Youth Self-Defense* Price: Δ