Impact Program Registration
Where: Program Schedule:
FaithWestwood UMC Monday-Friday 3:00 PM to 5:30 PM
4814 Oaks Lane Begins August 15, 2017
Omaha, NE 68137 Ends May 28, 2018
***We are not in session during holidays,
vacations, snow days or half days***
Contact Person:
Jessica Martinez Cost/Payment:
Impact Program Director Registration fee (secures spot in program) $25 Full-time (11 days or more a month) $175
895.3394 ext 1015 Part Time (6 - 10 days a month) $100
Daily rate (up to 5 days a month) $10

Child's Name *
Your answer
Child's Birthdate *
Your answer
Child's Grade (2017-2018) *
Will your student be: *
What days and times will your student be at Impact? Write estimated times for each day. *
Your answer
Are there any seasonal activities that may affect these estimates? If yes, which seasons will change? *
Your answer
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