Urban Youth Impact: Summer Jam Registration 2024

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Urban Youth Impact: Summer Jam

Dear Parents/Guardians,


We are very excited that you have expressed an interest in Urban Youth Impact's summer program, Summer Jam! Summer Jam will include regularly scheduled academic lesson plans, spiritual enhancement activities, field trips, life skills, and team-building challenges. 

The goal of Summer Jam is to make camp exciting, engaging, realistic, and most of all, memorable for all the campers. This will involve multi-sensory activities on Urban Youth Impact campus as well as field trip opportunities.


Please read the following important information regarding Summer Jam:

Summer Jam dates are 

June 17th- July 12th, 2024

Summer Jam begins on Monday, June 17th and ends on Friday, July 12th. Hours of operation for Summer Jam are 9:00 am- 3:30 pm, Monday through Friday and dismissal is 3:30 - 3:45 pm. Please review the handbook with  your child(ren) for more information about the summer program. The handbook will be sent to you prior to enrollment for your electronic signature. 

Summer Jam applications must be completed by Friday, May 31st, 2024 for priority enrollment. Please note that children currently enrolled in TLA and living in the Tamarind Avenue Corridor take priority enrollment. Applications are accepted on a first come first serve basis. 

We provide breakfast, lunch and snack everyday of Summer Jam.  In the event that we are unable to do so, parents/guardians will be required to provide lunch for their children. 

Summer Jam is a free program and there is no fee for tuition, food, or field trips. 


If you have any other questions, comments and/or concerns, please do not hesitate to contact the front desk at 561-832-9220.

Kind regards,

Carly Kidd

TLA Program Manager

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Only one child per application. Summer Jam ages are current K-7th Grades. This application must be completed by Friday May 31st, 2024 to be considered for priority enrollment.

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


Child's Information


Home Address


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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".

*Note that UYI will contact a different physician if we are unable to contact the child's primary care physician*
All Information is Confidential

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Family Data

Please use proper capitalization. 

Parent or Legal Guardian's Information

Please add (Name - Relationship - Phone Number)

Emergency Contact's Information


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The transportation radius listed below is our transportation zone. 

North: 39th Street

East: (From North to South) Broadway/ Rosemary

West: (From North to South) Australian/Mangonia Circle/7th Street

South:  2nd Street

Azure Estates (must live in Azure Estates)

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 for your child.***


Signature/Authorization to Review