Referral/Registration Form

To Register by Phone, call 1-888-861-8300, then Mail or Fax Referral Form to our office indicating location and date of class.

Our mailing address is: IMPACT WEEKEND 3509 Auburn Road Auburn Hills, MI 48326

To Register by Email, open and fill out the .PDF registration form below, Save the completed .PDF form to your desktop, then email the completed .PDF form to impactweekendsharon@gmail.com

Please be advised that Impact Weekend has and will enforce a ZERO Tolerance Policy involving medical marijuana.

Authorize.Net

You are required to submit the payment for your IMPACT Weekend through Authorize.net via one of the links below.

Sentencing Order / Referral / Registration Form

To Register by Email, download/open the 2024/25 Sentencing/Referral/Registration .PDF form via the link below. Complete the .PDF registration form in it's entirety, save the completed .PDF form to your desktop and email the completed .PDF form to impactweekendsharon@gmail.com

Open | Download Form Here

Authorize.Net

Sentencing Order / Referral / Registration Form

NOTE: Payment plans are available. Please contact us to discuss how we can best assist you.