Register your 6th-12th grade student(s) for MPact 2018 by completing & submitting this form. You may only register students for which you are legally responsible, but up to 3 students may be registered with this form, if needed.  A confirmation email will be sent to you upon submission.

*ALL STUDENTS UNDER THE AGE OF EIGHTEEN (18) MUST BE REGISTERED FOR MPACT 2018 BY A PARENT OR LEGAL GUARDIAN, WITHOUT EXCEPTION.*

Event Info: April 20-22, 2018
Fees: $20 per student, before or on 4/20
Register for MPact
 
Are you registering your student(s) with FBC Rockport or Coastal Oaks Church? *


 
Parent's FIRST and LAST name? *

 
What is the easiest number at which to contact you, {{answer_GBpwXQ1rvhp4}}? *

10 numbers only, no dashes or spaces.
 
What type of contact number is this? *


 
What is your mailing address, {{answer_GBpwXQ1rvhp4}}? *

Please include city/state/zip
 
DECLARATION OF GUARDIANSHIP
I, {{answer_GBpwXQ1rvhp4}}, am the parent or legal guardian for all 6th - 12th grade students listed on this form, and I am permitted by Law to complete this form as such. *

     
 
DECLARATION OF PERMISSION
I, {{answer_GBpwXQ1rvhp4}}, do hereby grant permission to all students registered on this form, for whom I am legally responsible, to participate fully in MPact 2018. *

     
 
If you answered "No" or "Permission Denied" to this question, please close this window. There is no need to finish the registration process for MPact 2018.

 
Student #1 FIRST and LAST NAME *

 
Is {{answer_vDhYaJejHySs}} a male or female? *


 
What grade is {{answer_vDhYaJejHySs}} in? *


 
How old is {{answer_vDhYaJejHySs}}? *


 
What size t-shirt does {{answer_vDhYaJejHySs}} wear? *

Adult sizes

 
Are there any allergy, medical, or physical ability/disability concerns for {{answer_vDhYaJejHySs}} about which your student ministry leaders should know? *

     
 
Please explain why you answered "yes" the previous question. *

 
Do you have another student to register for MPact? *

     
 
Student #2 FIRST and LAST NAME *

 
Is {{answer_JkK5bUf72nOZ}} a male or female? *


 
What grade is {{answer_JkK5bUf72nOZ}} in? *


 
How old is {{answer_JkK5bUf72nOZ}}? *


 
What size t-shirt does {{answer_JkK5bUf72nOZ}} wear? *

Adult sizes

 
Are there any allergy, medical, or physical ability/disability concerns for {{answer_JkK5bUf72nOZ}} about which your student ministry leaders should know? *

     
 
Please explain why you answered "yes" the previous question. *

 
Do you have another student to register for MPact? *

     
 
Student #3 FIRST and LAST NAME *

 
Is {{answer_l0jWuY3wugeL}} a male or female? *


 
What grade is {{answer_l0jWuY3wugeL}} in? *


 
How old is {{answer_l0jWuY3wugeL}}? *


 
What size t-shirt does {{answer_l0jWuY3wugeL}} wear? *

Adult sizes

 
Are there any allergy, medical, mobility, or physical disability concerns for {{answer_l0jWuY3wugeL}} about which your student ministry leaders should know? *

     
 
Please explain why you answered "yes" the previous question. *

Your registration information has been sent, and you are now one step closer to experiencing the awesomeness of MPact 2018!

A copy of this registration has been sent to the email address you provided.

NOTE: Registration is fully complete for MPact 2018 when the $20/student event fees have been paid to the business office of your home church.  If you have questions about this, contact your student pastor.