Impact Week 2025 Registration

Parent/Guardian Name

Parent/Guardian Email

This address will receive a confirmation email

Parent/Guardian Phone Number

I am registering

Myself A student

Student's Name

Student's age

What days are you/your student participating?

Tuesday Wednesday Thursday

Do you or does the student have any food allergies or dietary restrictions?

Liability Release & Authorization I certify the information provided is correct to the best of my knowledge. In the event of an emergency, I give permission to the directors of the activity to render First Aid, as well as permission to a licensed physician to hospitalize, anesthetize, or perform surgery on the person/s listed. I understand that every reasonable effort will be made to make contact with the prior mentioned emergency contact before these actions are taken. I acknowledge that I am responsible for payment of medical charges or expenses not covered by my insurance or the insurance applicable to my child (if any). I further agree to hold harmless and indemnify the church staff in charge of Impact Week, volunteers, and Impact Week churches from any and all claims for damages arising out of personal injuries sustained by my son/daughter/ward during any activities while serving during Impact Week or authorized off property events. I understand that photographs and/or video/audio recording made during Impact Week programming may include my child, and I authorize use of such photographs or recordings at the discretion of Impact Week churches. I understand that transportation will be provided by legally licensed adults and give permission for my child to ride in vehicles driven by certified staff and volunteers. I hereby fully and forever release and discharge all church staff and volunteers from any and all said claims.

Agree

Description

July 23-25

Impact Week is several United Methodist Churches working together for students to make an impact in our community. 6th-8th grade students will work alongside adult helpers on various service projects June 24-26 and enjoy a fun activity Thursday afternoon. The cost is $20 per participant.

Impact Week 2025 Registration

Description

Please Fix the Following