2017 Winter Service Camp

Our service camp this summer was such a hit, we’ve brought it back for winter break!

Spend winter break helping others and having a blast as we:

  • Experience the joy of giving
  • Learn about real issues kids face like hunger and lack of clean water
  • Grow your leadership skills
  • Complete service projects that will really make a difference



Date: Dec. 18 – 21, 2017

Time: 9 am – 3 pm

Location: Cedar Run Community Church

13560 McLearen Rd, Herndon, VA 20171

Cost: $250


Child's Name*

Child's Age*

Child's School Grade*

Parent's Name*

Parent's Email*

Parent's Contact Number*

Parent 2 Name*

Parent 2 Email*

Parent 2 Contact Number*

Parent’s Mailing Address*




Emergency Contact Name*

Phone 1*

Phone 2*

Emergency Contact 2 Name*

Phone 1*

Phone 2*

Any known allergies or health concerns?

Any medication that will need to be with the child during the camp? (Such as epipen, inhaler, etc...)

Is there anything else we need to know about your child?
(ie: specific needs, accomodations required, dietary modifications, etc...)

Person(s) authorized to pick up child at end of day.

Camp Cost: $250

I have read and agree to the releaseAgree

I understand that by signing up for the camp, my child will be photographed for Touching Heart marketing.

*NOTE* Submitting this form will register your child for this event and take you to our PayPal page for payment. Your child's spot is not confirmed until you receive a receipt of payment from PayPal.