Home
I'm New
About
Leadership
What We Believe
Mission and Vision
IC Network
Impact Kidz Club
Impact Kidz
Impact Kidz Academy
Ministries
Calendar
Give
Contact
Community Market
VBS 2025 Sign Up
Sign Up Today for our free vbs june 23rd-27th
First Name
Last Name
DOB
Child's Age
Child's Gender
Last School Grade Completed
Name Of Parent(s)
Email
Parent/Caregiver's Phone Number
Address
Apartment, suite, etc.
City
State
Postal / Zip Code
Home Church
Allergies, Medical Conditions, Or Special Needs
In Case Of Emergency...
Emergency Contact
Phone Number
Relationship To Child
Please Note*
In registering your child you are giving permission to Impact Church to take and post pictures of your child.
<
Back
Next
>
Submit