TKC IMPACT Summer Camp Registration Form

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TKC Impact is an exciting and dynamic ministry geared at today's teens. Impact seeks to be a place that is safe and welcoming to any kind of kid. Through fun and fellowship, we hope to form deep and lasting relationships that will have an unspeakable impact on the youth of Northern Virginia. Impact is the youth group of The King's Chapel, a fast-growing evangelical church located in Fairfax.

Check out pictures from last year's summer camp! Watermarks 2009

2010 SUMMER CAMP DATES: July 25-30, 2010

TIMES: Leave from The King's Chapel church at 1:00 p.m. on Sunday, 7/25

Return to TKC at 3:30 p.m. on Saturday, 7/30

LOCATION: Concord, WV

COST: $450- $50 deposit, if already paid

(Checks payable to The King's Chapel, due no later than July 25)

Check out what you get when you go on the retreat of a lifetime!

A week away from home with friends
Great food (seriously, legit!)
Awesome worship
Dynamic speaker
Paintball...enough said
Cabin-style rooms in comfortable lodges with several bathrooms and AC
Gian game room with Ping Pong, Pool, Bumper Pool, Air Hockey, Foosball, etc.
Beach Volleyball
Basketball Courts
Sick games like Death-hack, 4-square, and Ninja
Lots of trails and obstacle course
Free stylish T-shirt
And more (but seriously, there's more!!)

THE SHORT LIST OF WHAT TO BRING

Personal toiletries
Clothes for a week of running around and hanging out
Clothes you can get dirty--and maybe throw out!
Bathing suit (be modest!)
Bible/notebook (if you have one)
No booze, drugs, weapons, etc...

Register Here for Summer Retreat 2010 in Concord, West Virginia!

DIRECTIONS FOR COMPLETING THE FORM

Use your TAB button to get from field to field. Please delete any directions or sample text in each field before completing it. Please submit one form for each youth you want to register.

PLEASE NOTE: You must click the Submit Button at the bottom of this form for your registration to be complete. If you do not click Submit, we will not receive your registration, and we will not be prepared for you (carpool, food, T-shirts, etc.) on the trip!!

Name:

Date of Birth: Best Phone:

E-mail:

Special Needs/Allergies/Medical Conditions:

I am a friend of

____________________________________________________

Parent Name(s):

Address:

Best Phone: Alternate Phone:

E-mail:

____________________________________________________

Please check "yes" if Emergency Contact is same as parent above: Yes No

Complete emergency contact info only if "no" checked above.

Emergency Contact Name:

Emergency Contact Phone: Relationship to Youth:

____________________________________________________

Click here to for Parent Approval and Medical Release Form. You must bring in this signed form and any money due before you will be allowed to go on this trip.

Medical Insurance Carrier:

Carrier Phone:
Policy Holder:

Policy #: Group #:

____________________________________________________

Comments/Suggestions (Please let tell us about your experience with this form of registration and/or how we can improve the form):

Submit Registration Form to The King's Chapel

PLEASE NOTE: You must click the Submit Button above for your registration to be complete. If you do not click Submit, we will not receive your registration! Unfortunately, we cannot send an automatic response to say we've received your registration--but we haven't missed one yet! If you have any doubt, please contact Chris Craddock at chris.craddock@thekingschapel.org

Reset Registration Form to Register Someone New (Please note that this will reset ALL your information.):