Mpact Student Registration Form
Step 1 of 3: Submit
Please fill out this form for each student attending Mpact.
Church Name - No initials
*
Youth Pastor
*
Gender
*
Select an option:
Male
Female
Last Name
*
First Name
*
T-Shirt
*
Select an option:
S
M
L
XL
XXL
XXXL
XXXXL
CS
CL
Grade Completed
*
Select an option:
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Leadership Grid - Choose One
*
1 - Walking with Christ - Leader
2 - Trying to walk with Christ - Leadership potential
3 - Not sure about walking with Christ
Have you attended Mpact before?
*
Yes
No
*
indicates required fields