Camp Impact 2026 Form

Join Impact PCG for camp this July!

Kids - July 6th-9th (Cost $200 per student)
Teen - July 20th - 24th (Cost $220 per student)

1Camper Information > 2Emergency Contact and Medical > 3Rules, Policies and Signature
What Camp will your student be attending?

What Camp will your student be attending? Kids Camp (going into 1st grade - finished 5th grade) Teen Camp (going into 7th grade - Graduated 12th Grade)
Name Name First Last
Campers Date of Birth Campers Date of Birth / MM / DD YYYY
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email
Phone Phone - ### - ### ####
Name of Church you Attend
Shirt Size (Shirt Included in Fee)

Shirt Size (Shirt Included in Fee) Youth Small Youth Medium Youth Large Youth X-Large Adult Small Adult Medium Adult Large Adult X-Large Adult 2X-Large Adult 3x-Large
Are you permitted by legal guardian to swim at camp?

Are you permitted by legal guardian to swim at camp? Yes No
List any activities my camper will not be allowed to participate in.