Rally 2019 Group Registration Form

Group Registration and Roommate Form
Contact Youth Leader Name*

First NameLast Name
Contact Youth Leader Email*
This email will be used to correspond with you.
Contact Youth Leader Phone Number*

Area CodePhone Number
Church Name and Location*
Enter Full Church name and city and state
Will you have a vehicle available at the rally to transport all your participants to the Wednesday activity?*

YesNoUnsure
Male Participants
Male Youth Leader 1

First NameLast Name

Male Roommates 1

Male Roommates 2

Female Roommates 1

Female Roommates 2

Extra Female Leader?

First NameLast Name
Extra Female Leader?

First NameLast Name
Enter the message as it's shown*
No payment is required at this stage. You will receive an automatic email response once you click on the REGISTER button. In the email, there will be a link to make changes to your group submission prior to May 15. Changes after May 15 should be requested by contacting us directly.
Should be Empty:

Group Registration and Roommate Form