Summer Jam Registration
Iowa City First Assembly of God will host Summer Jam June 12th - August 4th M-F. Breakfast and Lunch will be served for all children/teens under the age of 18. The program will include educational activities, community workshops, fun and games! The program will focus on preschool-elementary aged kids between breakfast and lunch and will be open for a teen hang out after lunch. All are welcome.
Student Name (First, Last) *
Your answer
What grade will your student be going into next year?
Parent/Guardian Name (First, Last) *
Your answer
Parent/Guardian Phone *
Your answer
Your answer
Medical Concerns? *
Your answer
Allergies? *
Your answer
Any Other Pertinent Information?
Your answer
Do We Have Permission To Post Pictures Of Your Student On Social Media? *
In the case of an emergency do you give our staff/volunteers permission to seek appropriate medical help for your student? *
Do you have a preferred hospital?
Your answer
If at any point staff/volunteers deem it necessary for your student to go home (illness, behavior issues, etc.) it is your responsibility to pick them up, or give them permission to walk home. Do you understand and agree to these terms? *
Does your child have permission to walk home? *
If you have any questions please contact Abby Anderson at 319-333-6687 or at
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