Impact Community
A Rethink Church Event
Impact JC
Making a Difference in our Community!
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I would like to volunteer for:*
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* required information
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Contact Information
First Name:
*
Last Name:
*
Email:
Phone:
Cell Phone:
Special Skills or Needs:
I attend one of the sponsoring United Methodist Churches:
Yes
Additional Information
I Would Like a Free T-Shirt:
Yes
T-Shirt Size:
-- please make a selection --
SM
MD
LG
XL
XXL
3XL
4XL
I WILL be attending the Celebration:
Yes
Impact Event Name:
*
Number of Celebration attendees (including myself):
How Did You Hear About This Event?:
*
-- please make a selection --
My Local Church
Friend Invitation
TV Ad
Radio Ad
Billboard Ad
Online Ad
Newspaper Ad
Direct Mail
Email
Social Media
Bus Ad
Other
Age:
*
-- please make a selection --
18-34
35-49
50-64
65+
Contact Me about Registering Youth, Ages 14-17:
Yes
Your Interest Area
Impact Community
Select all in category
I certify that I am 18 years of age.
I would like to receive Event Day Updates!
Anyone ages 14-17, please select 'Yes' in the Youth registration checkbox above so we can contact you. Children do not need to be registered.
By clicking submit, I certify that I am at least 18 years of age. Anyone under the age of 18 must be accompanied by a parent or guardian at all times during the event day in order to participate. Medical and photo release forms must be signed by all volunteers before participation begins. Forms will be provided at the event sign-in area.
Special Needs:
If you have physical limitations, your contribution is still very valuable to us. Please list any special needs you would like us to be aware of in the box provided above.
Special Skills:
If you have any special skills specific to this event, please let us know so we can place you where your skills are most needed. Please list skills in the box provided above.