Boys Camp Enrollment Form Sept/Oct 2026

Impact Boys Mentorship Camp

Registration Form Sept/Oct 2026
ATTENDEES INFORMATION:
Atendee's Names

First NameLast Name
Birth Date

MonthDayYear
Grade/Form
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 Boys Mentorship Camp