Boys Camp Enrollment Form 2025

Impact Boy's Mentorship Camp

Registration Form March/April 2025
ATTENDEES INFORMATION:
Atendee's Names*

First NameLast Name
Birth Date*

MonthDayYear
Grade*
T-shirt size
Name of School*
Who does the attendee stay with full time?
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Land LineMobile Number
E-mail*
MEDICAL INFORMATION
Doctors' Name

First NameLast Name
Phone Number

Emergency NumbersPhone Number
What medical condition does your child have? Include any medication he will be coming with and allergies.
Why do you want this teen-age boy attend the camp?
Should be Empty:

Impact Boy's Mentorship Camp