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2019 IMPACT Driver Application
Your answers to the following questions will help us place you with a team and designate a target zone in which you will be driving. Our hope is to build a sense of community within our teams and throughout our neighborhoods. Please respond to the following questions as clearly as possible.

Impact Clubs Dates:
June 17-20

Email address *
The Basics
Are you at least 21 years of age, have a valid driver's license, and current insurance?
How many passengers (not including yourself) can your car carry with a seat belt?
Can you come to the Friday night IMPACT Carnival on June 21?
Driver Information
Name
Your answer
Address
Your answer
City
Your answer
Zip Code
Your answer
Cell
Your answer
Please Select Which time slot you are available for.
All time slots for all four days
Morning Report @ 8:30-11:30 a.m.
Afternoon Report @ 12:45-3:30 p.m.
Evening Report @ 4:45-8 p.m.
A copy of your responses will be emailed to the address you provided.
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