IMPACT Youth Registration

Parent/Guardian: Please fill out the following registration form.

Here are some notes about the form before proceeding:

• You can register up to 5 youth (that you are responsible for) within this one form.
• Digital Signatures are required for each youth on the Youth Conduct form section, so be sure they are available when you fill this out.
• For each youth, there is a Medical Information section that is required to fill out.
• There is a choice to indicate if your church will be making payment or if you are.
• If you are making the payment, you will be redirected to the Tithely website after you submit the registration form. Once there, you will fill in your name and email. Then add the names of each youth in the attendee fields. Each youth cost $90.

If you need additional help or have questions, please contact April Johnson at impactyouth.lcmc@gmail.com