Urban Youth Impact: Summer Jam Registration 2019

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Dear Parents/Guardians,

 

We are very excited that you have expressed an interest in the Urban Youth Impact's summer camp program. Summer Jam is a fun-filled seven week day camp for rising 1st grade (moving into 2nd) through rising 8th grade (moving into 9th) campers. There will be regularly scheduled academic lesson plans, spiritual enhancement activities, life skills, team-building challenges, and a plethora of weekly scheduled field trips and  fun activities.  


The goal of Summer Jam is to make camp fun, exciting, engaging, realistic, and most of all, memorable for all the campers. It is scheduled to run from June 24th to August 9, 2019 from 9:00 a.m. until 4:00 p.m., Monday through Friday.  This year's theme is: All the World's a Stage. Students will creatively learn how to face life's dramas of fear, distraction, apathy, pain, confusion, division, and hope through a 7-week study in the Book of Revelation.


Due to limited occupancy, we will be accepting applications on a first come, first serve basis and filling spots based on grade levels. Therefore, parents/guardians are encouraged to register their child and/or children, as soon as possible.  Once maximum camp capacity is met, all other applicants will be added to the wait list.  So please do not delay to register in advance.  


Please read the following important information regarding Summer Jam details:

 

·     The online application must be filled out completely before being submitted for review.  

.     Health Insurance information MUST be provided in order for the form to be considered complete.

 ·    Applications are only considered for students moving into 2nd grade through 9th grade, in the upcoming school year.

·     There will be a $50.00 application fee for the first child and an additional $35.00 fee for each additional child accepted for enrollment. Registration fees are due after acceptance and consent of participation in camp.

.     Summer Jam will include daily breakfast and lunch for each camper.

.     There will be scheduled weekly field trips.  Signed field trip forms are required prior to participation.  

·    If you are interested in transportation to and from Summer Jam, there is an additional transportation fee of $50/per household  to pick-up and drop-off or $25/per household, if only one way service is needed.


If transportation is requested by UYI, the buses and vans will only be traveling within the following West Palm Beach radius: 

      Northbound: As far as 25th Street

      Eastbound: Spruce Avenue

      Westbound: Congress Avenue: Hank Aaron/Fire Station

      Southbound: As far as 2nd Street


Students will be picked up and dropped off at the provided address, unless driving restrictions prevent it.  In such cases, other drop off arrangements will be made.  Final transportation information will be provided for all selected applicants once final route details are determined.


If you have any other questions, comments and/or concerns, please do not hesitate to contact the Urban Youth Impact administrative office.  


*** Please note, submitting an application online, is not a guarantee that your child will be selected for Summer Jam. All applications will be reviewed upon receipt and consideration will be based upon availability within the grade you are applying for. Once your child has been selected, a notification from UYI will be sent to you about the next steps. Please remember to check your email regularly. ***


 

Kind regards,


Summer Jam Program Management Team

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Only one child per application.  There will be a $50.00 fee for the first child and a $35.00 fee for each additional child. Submission of application does not guarantee that your child will be accepted into the program.  You will be notified when your child is accepted.  


*Please notify Urban Youth Impact if any of the following information changes*



MM/DD/YYYY




Child's Information




MM/DD/YYYY



Home Address











ALL INFORMATION IS KEPT CONFIDENTIAL

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Child's Info (cont'd)



If None Please type "None".




If None please type "None".

If None, please type "None".




Authorization For Insurance (Required Info)

In the event of an injury or illness that may require medical attention from a physician or clinic, please note your child's medical care must be covered by your primary health insurance carrier.  If your child is currently without healthcare coverage, you are solely responsible for any medical expenses incurred.


If no Insurance, please put None.

If None, Please type "None".



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Family Data

Parent or Legal Guardian's Information













Please use proper capitalization. 




Emergency Contact's Information






Please add (Name - Relationship - Phone Number)

ALL INFORMATION IS KEPT CONFIDENTIAL

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Transportation
Transportation Fee: $25 for one way service either pick up or drop off OR $50 for both pick up and drop off service. The fee would apply to entire household.

If transportation is requested by UYI, the buses and vans will only be traveling within the following West Palm Beach radius: 

      Northbound: As far as 25th Street

      Eastbound: Spruce Avenue

      Westbound: Congress Avenue: Hank Aaron/Fire Station

      Southbound: As far as 2nd Street



Mark N/A if not applicable

Mark N/A if not applicable
*** Please note: If you do not live in our transportation zone, it will be your responsibility to provide transportation to and from program from your child.

ALL INFORMATION IS KEPT CONFIDENTIAL

Signature/Authorization to Review