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In addition to the registration form below, please download the Arizona Youth Impact Program Waiver Forms after registration. You can email completed forms to info@youthimpactprogram.org and bring them in person to the draft night.

2024 ARIZONA YIP REGISTRATION FORM FOR GIRLS

Please use this form to register for the 2024 Girls Arizona Youth Impact Program at the University of Arizona June 17-28 (Monday - Friday - no program on June 19)

YOUTH INFORMATION

Gender(Required)
Address(Required)
MM slash DD slash YYYY
Does the Youth Participant have knowledge of STEM?(Required)
If none, please write none or n/a

Parent Guardian Information

Emergency Contact information

Statement of Responsibility:

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