Every Tuesday Morning In July 9:30AM-NOON

Sign Up Today For Impact Kidz Camp!

First Name (Child)

Last Name (Child)

DOB

Child's Age

Child's Gender

Last School Grade Completed

Name Of Parent(s)

Street Address

City

State

Zip Code

Parent/Caregiver's Cellphone

Email Address

Home Church

Allergies, Medical Conditions, Or Special Needs

In Case Of Emergency..

In Case Of Emergency, Contact

Phone Number

Relationship To Child

Please Note
In registering your child you are giving permission to Impact Church to take and post pictures of your child.

Select What Days Your Child Will Attend
Tuesday, July 2nd Water Games
Tuesday, July 9th Slime Making
Tuesday, July 16th Soccer/Field Day
Tuesday, July 23rd STEM
Tuesday, July 30th Water Games

The Price Is $10 per Tuesday, $40 for all 5 weeks. Please select the Impact Kidz Camp option on the fund menu down below to pay.

Payment
I have paid in advance for registration of my child.
I have not paid for registration. I will pay in person.
I will pay online.

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