IBC PreK Moms AM Registration 2023/24

If you are a current group member or have received notification that you have been moved from the waitlist to active membership, you may now register below for the 2023/24 season.

Today's Date

Name

This address will receive a confirmation email

Cell Phone

Address

Birth Date

Husband's Name (if applicable)

Home Church (if applicable)

How did you hear about us?

Please provide the name(s), gender, and birth date(s) for each child who will be in our Childcare program during the PreK Moms meetings.

Please list any allergies or special instructions for child(ren) who will be in our Childcare program.

Name & cell number of individual(s) authorized to pick up child(ren) in case of an emergency.

Scholarship Please contact me with scholarship info.

2023/24 Registration Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

If you are a current group member or have received notification that you have been moved from the waitlist to active membership, you may now register for the 2023/24 season. Please fill out this form and click submit.

IBC PreK Moms AM Registration 2023/24

Description

Please Fix the Following