City Impact Programs | City Impact

Train up a child in the way they should go: and when they are old, they will not depart from it.

– Proverbs 22:6

CI Faith Resumes 5:30PM – 7:30PM, February 9th, 2023

CI Bible Club teaches kids to see themselves as God sees them, and how to live a kingdom life.

Bible Club helps kids get to know themselves in God’s story in an environment where they are seen, and safe and can grow a bigger view of God. Our bible club uses a fun, interactive, game-based curriculum that teaches K-5th graders about the love of God while fostering long-term relationships with caring adults.

CI Bible Club features playful activities, prayer, and a balanced meal.

Online registration closes February 6th. Apply now! If registration fills up, your child will go on our waitlist and you will be contacted if/when a spot becomes available.

Two ways to register!

Click on the “Application” tab at the top of this page to submit your application online.
Go to City Impact (1035 North 33rd Street Lincoln, NE 68503). In person registration at City Impact Center is open Monday-Friday, 8:30AM-4:30PM and on Saturday January 21, 28, and February 4 from 9 AM – 11 AM (CST).

CI Faith Program Application

Registration closes on Monday, February 6th @ 6:30 PM (CST).

Complete the form below to register your child for the CI Faith Program.

The CI Faith Program is open to all Kindergarten - Fifth grade students. Registration closes on Monday, February 6th @ 6:30 PM. Click the “Add Another Student” button to register up to 4 students at once. We will email a confirmation when we receive your application. Further details will be emailed closer to the February 9th start date.

Student Information

Student Contact Information

Student First Name *0 / 80

Student Last Name *0 / 80

Student Date of Birth *

Child’s Grade in School? *

What school does the child attend?0 / 100

Do you give permission for City Impact to contact the students school/teacher? *YesNo

Student Address 1 *

Student Address 2

Student City *

Student State *

Student ZIP / Postal Code *

Do you give permission for City Impact to use your child's photograph/image for marketing purposes? *YesNo

Parent/Guardian Information

Parent/Guardian First Name *0 / 80

Parent/Guardian Last Name *0 / 80

Parent/Guardian Email *

Parent/Guardian Phone *0 / 12

Is Parent/Guardian address the same as the students address? *YesNo

Parent/Guardian Address 1

Parent/Guardian Address 2

Parent/Guardian City

Parent/Guardian State

Parent/Guardian ZIP / Postal Code

Emergency Contact Information

Emergency Contact First Name *0 / 80

Emergency Contact Last Name *0 / 80

Emergency Contact Email

Emergency Contact Phone *0 / 12

Questions

Help us get to know your child a bit before the program begins.

Answer the following questions. We’re looking forward to working with you and your child!

City Impact Employee who referred you?

CI Employee First Name

CI Employee Last Name

What are the top 3 things you want your child to get out of the program? *0 / 100

What are some of their interests? *0 / 100

What are some of their dislikes? *0 / 100

Describe their areas of strength in school?0 / 100

Describe areas in school that you feel need improvement?0 / 100

Does your child have any allergies, including food(s)? *YesNo

Please provide some details about their allergies.0 / 100

Does your child have any health concerns, health conditions, or special needs? *YesNo

Please provide some details about their health concerns, health conditions, or special needs.0 / 100

My child can be dropped off/picked up by the following people:

Drop-Off/Pick-Up Contact First Name0 / 80

Drop-Off/Pick-Up Contact Last Name0 / 80

Drop-Off/Pick-Up Contact Email

Drop-Off/Pick-Up Contact Phone *0 / 12

Relationship to the child?

Attendance Policy Consent

Our attendance policy is as follows:

Program will begin at 5:30 PM and end at 7:30 PM.
Students must arrive on time (10-15 minutes before start time) at City Impact.
Students must be picked up promptly at 7:30 PM at the conclusion of the program.
Attendance at each session is important!

Do you agree with this attendance policy? *YesNo

You declined consent to the attendance policy,

Someone from our staff will contact you to discuss.

Signatures

Students Full Name *By completing this field you are enering a legal "Digital Signature".0 / 80

Student Written Signature

Sign your written signature here using a fingertip or stylus. By completing this field you are enering a legal "Digital Signature".

Parents Full Name *By completing this field you are enering a legal "Digital Signature".0 / 80

Parent Written Signature

Sign your written signature here using a fingertip or stylus. By completing this field you are enering a legal "Digital Signature".

Send me CI Faith Program email news and updates:YesNo

Visit the City Impact Center to apply in-person.

City Impact Center
1035 North 33rd Street
Lincoln, NE 68503

In person registration at City Impact Center is open Monday-Friday, 8:30AM-4:30PM and on Satuday January 21, 28, and February 4 from 9 AM – 11 AM (CST).