diff --git a/client/src/pages/signup.js b/client/src/pages/signup.js
new file mode 100644
index 00000000..54d91dc4
--- /dev/null
+++ b/client/src/pages/signup.js
@@ -0,0 +1,114 @@
+import React, { useState } from "react";
+import { Layout } from "../modules/layout";
+import {
+  Stack,
+  Button,
+  Heading,
+  FormControl,
+  Input,
+  FormHelperText,
+  FormLabel,
+} from "@chakra-ui/react";
+
+const SignupPage = () => {
+  //create input values
+  const [firstname, setfname] = useState("");
+  const [lastname, setlname] = useState("");
+  const [email, setemail] = useState("");
+  const [address, setaddress] = useState("");
+  const [dob, setdob] = useState("");
+  const [password, setpassword] = useState("");
+  const [zip, setzip] = useState("");
+
+  const handleSubmit = (e) => {
+    //check if every input is valid
+    //if all inputs are valid, complete registration
+  };
+
+  return (
+    <Layout>
+      <Stack>
+        <Heading>Sign Up</Heading>
+        <Form onSubmit={handleSubmit}>
+          <FormControl id="firstname" isRequired>
+            <FormLabel>First Name</FormLabel>
+            <Input
+              type="text"
+              value={firstname}
+              onChange={(e) => {
+                setfname(e.target.value);
+              }}
+            />
+          </FormControl>
+          <FormControl id="lastname" isRequired>
+            <FormLabel>Last Name</FormLabel>
+            <Input
+              type="text"
+              value={lastname}
+              onChange={(e) => {
+                setlname(e.target.value);
+              }}
+            />
+          </FormControl>
+          <FormControl id="email" isRequired>
+            <FormLabel>Email address</FormLabel>
+            <Input
+              type="email"
+              placeholder={"example@email.com"}
+              value={email}
+              onChange={(e) => {
+                setemail(e.target.value);
+              }}
+            />
+          </FormControl>
+          <FormControl id="password" isRequired>
+            <FormLabel>Password</FormLabel>
+            <Input
+              type="password"
+              value={password}
+              onChange={(e) => {
+                setpassword(e.target.value);
+              }}
+            />
+          </FormControl>
+          <FormControl id="dob">
+            <FormLabel>Date of birth</FormLabel>
+            <Input
+              type="date"
+              value={dob}
+              onChange={(e) => {
+                setdob(e.target.value);
+              }}
+            />
+          </FormControl>
+          <FormControl id="address">
+            <FormLabel>Address</FormLabel>
+            <Input
+              type="text"
+              placeholder={"123 A Ave NY,NY"}
+              value={address}
+              onChange={(e) => {
+                setaddress(e.target.value);
+              }}
+            />
+          </FormControl>
+          <FormControl id="zip" isRequired>
+            <FormLabel>Zipcode</FormLabel>
+            <Input
+              type="text"
+              value={zip}
+              onChange={(e) => {
+                setzip(e.target.value);
+              }}
+            />
+          </FormControl>
+          <FormControl id="country">
+            <FormLabel>Country</FormLabel>
+            <Input type="text" />
+          </FormControl>
+          <Button type="submit">Register</Button>
+        </Form>
+      </Stack>
+    </Layout>
+  );
+};