After School Program Pre-Registration Interest Form

Journey Church is in the process of raising funds and planning for an After School program at a new facility located on Highway 45 in Guntown, Mississippi. This online form is to generate interest and in no way represents or guarantees registration for your child.

We need to generate interest and see if the need can be met by Journey Church. If you are interested in your child attending a Christian based After School program in Guntown around the fall of 2017, please fill out the form below.

We will keep you updated and let you know the status of this amazing ministry that Journey Church hopes to soon provide.

PARENT/GUARDIAN: As the person who can responsibly show interest and desire to enroll your child/children in the Journey Church after school program, please enter YOUR information below..

YOUR FIRST NAME

YOUR LAST NAME

YOUR EMAIL

YOUR PHONE

Due to the fact that some people may have one child and some may have multiple children, please type into the box below the child's name, then age, then grade, then their school name on one line and each child on separate lines.

CHILDREN NAMES / AGES / GRADE / SCHOOL

EXAMPLE SCHEDULE: We are still in the planning stage, but an example of the daily schedule would be:

Refreshments/Healthy Snack

Age Group Breakouts

Homework Time

Specific Tracks (music, art, singing, crafts, photography, etc..)

The times would be from around 3:00 pm - 6:00 pm or so.

Estimated cost would be $50 per child per week.

Success! This form has been submitted. Your submission does not guarantee your child a registration spot. We need to gather as much interest as possible to obtain our funding and continue planning this ministry. Thank you so much for showing interest and we will keep you updated in the Summer of 2017 of our progress. Please let other people know about this possible After School program so we can better guage interest and possible attendance - encourage them to fill this form out also. The more interest and names we can gather, the better understanding we will have of makling this a reality. Thank you so much!