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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