VOH Registration

Application For (Required) *

Summer Day Camp Afterschool Program

Application Steps

Household

Step 1 of 6

Please complete one form per family and add each child in the next section.

Parent / Guardian Information

Enter the primary parent or guardian's information.

First Name (Required) *

Last Name (Required) *

Cell Phone (Required) *

Alternate Phone (Optional)

Email Address (Required) *

Home Address

Street Address (Required) *

City (Required) *

State (Required) *

ZIP Code (Required) *

Employer (Optional)

Job Title (Optional)

Preferred Communication (Required) *

Phone Text Email Any

Custodial Parent? (Required) *

Yes No

Ethnicity (Optional)

Add another parent or guardian if applicable.

First Name

Last Name

Cell Phone

Alternate Phone

Email Address

Home Address (Optional)

Street Address

City

State

ZIP Code

Employer

Job Title

Children / Youth Information

Step 2 of 6

Add each child applying for the program.

Emergency Contacts / Authorized Pickup

Step 3 of 6

List all individuals authorized to pick up your child.

Release & Custody Rules

Allow release to authorized sibling under 18?

Family, Household, and Church Information

Step 4 of 6

Church Name

Pastor's Name

Church Address

Church Phone Number

Number in Household (Required) *

Free / Reduced Lunches (Required) *

Household Type (Required) *

Annual Household Income (Required) *

How did you hear about Voice of Hope Summer Camp? (Required) *

Eligibility Quick Check

Please check any that apply

Single parent working at least 25 hours/week Two parent household working at least 50 combined hours/week Household meets income guidelines

Medical & Health Information

Step 5 of 6

Complete this section for each child.

Please add children in Step 2 first.

Your progress will be saved and you can return later.

VOH Registration