Summer Summer Camp Registration
WHAT: FREE Summer Sports Camp for rising 1st - 6th graders
WHEN: July 15 - 19, 5pm - 8pm
WHERE:  Luther Jackson Middle School (3020 Gallows Rd, Falls Church, VA 22042)

COST:  FREE for all in the community, but you MUST REGISTER and complete the release form before or during camp registration --> http://tinyurl.com/mcccampform

For more info, contact office@mosaiccitychurch.com or (703) 539-2104
Child’s name/Nombre del Niño(a): *
Age/Edad: *
Rising Grade next fall/Grado que le toca el próximo otoño: *
Second child's name/Segundo nombre del niño(a)
Age/Edad:
Rising Grade next fall/Grado que le toca el próximo otoño:
Third child's name/Tercero nombre del niño(a)
Age/Edad:
Rising Grade next fall/Grado que le toca el próximo otoño:
Parent/Guardian Name/Nombre del padre(s)/guardian: *
Email Address/Dirección de Correo Electrónico *
Address/Dirección: *
Phone Number/Número del: *
List any allergies or medical conditions / Escriba cualquier alergia o condicion medica: *
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