First Name:

Last Name:

EVENT: select an event... Junior Impact (sign up Feb 11) Senior Impact (sign up Feb 11) Spring Retreat (sign up March 4)
*These events are not yet available for online sign up.

If you sign up online for IMPACT, Paul will contact you concerning the
forms you must complete and the $25 payment that is due when you sign up.

Address:
City: State: Zip:

Phone Number: - -

Grade:
Gender: Male .... Female

Have you turned in a Medical Release Form? YES .... NO
If not, click this link and fill out the form.

If visiting, I am coming with:


EMAIL Address: (REQUIRED)

(you must fill in all fields)