IMPACT 2015 Group Registration

Group leaders: Use this form to begin your registration for IMPACT 2015.

Please note that your registration will not be complete until our office receives your DEPOSIT.

*Required fields










Be sure to check your email regularly. I will use it to communicate with group leaders regarding deadlines and update information.

You may reserve spots by submitting this application AND either paying online or by mailing a deposit to the address listed at the bottom of the form.

NOTE:Everyone who will be on campus and/or attending IMPACT, including campers, youth ministers, chaperones, spouses, and children age 7 and up, will need to reserve a spot for IMPACT. There is no charge for children 6 and under.


Number of spots to reserve for:


Payment Options

Total Number of Spots X $25.00 = _________ (Deposit amount to be paid)

Note: Do not fill out the Credit Card information if you are paying by check


Payment by Check

Mail deposit checks to: IMPACT, Lipscomb University, One University Park Drive Nashville, TN 37204

Payment by Credit Card

Note: Entering in an amount in this box will bring up another form to enter in your credit card information when you click Submit Form at the bottom of this page.