IMPACT Kidz Ministry

We are currently updating our church database so please fill out each box with the correct information. Also for security purposes, we are asking for a photo of your child that will be inserted into our database and will print out on your child's name tag.

Thanks,
IMPACT KIDZ Staff

Parent/Guardian Information

Parent/Guardian #1

*

Relationship to the child/children

*

Parent/Guardian #2

Relationship to the child/children

Email

*

This address will receive a confirmation email

Email

Phone

*

Phone

Address

*

Address

Are you interested in volunteering?

*

Please select one option.

Yes No

At different times throughout the year, we take pictures and video clips of our children events. Does IMPACT Kidz of Eastview Wesleyan have your permission to post your child's picture or video that they may be a part of on the church Facebook, Website, Newsletters, or church announcements?

*

Please select one option.

Yes No

Children Information

Name

*

Birthday

*

Age

*

Gender

*

Please select one option.

Male Female

School

*

Grade

*

Hobbies

Allergies

*

Upload Photo (see description)

Upload (8MB)

Name

Birthday

Age

Gender

Please select one option.

Male Female

School

Grade

Hobbies

Allergies

Upload Photo

Upload (8MB)

Name

Birthday

Age

Gender

Please select one option.

Male Female

School

Grade

Hobbies

Allergies

Upload Photo

Upload (8MB)

Name

Birthday

Age

Gender

Please select one option.

Male Female

School

Grade

Hobbies

Allergies

Upload Photo

Upload (8MB)

Description

We are currently updating our church database so please fill out each box with the correct information. Also for security purposes, we are asking for a photo of your child that will be inserted into our database and will print out on your child's name tag.

Thanks,
IMPACT KIDZ Staff

Please Fix the Following

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