2018 Youth Rally Registration

Every Participant Must Complete This Form!!!

Name of Congregation Or Church Youth Group*

Primary Contact Information

Contact Person*
Phone Number:*
-
E-mail Address:*
Chaperone(s)- Please give the names of each and if housing is required for each.

Female Youth In Attendance

Please give the names of each and their grade or age(Female)*

Male Youth In Attendance

Provide the names of each and their grade or age(Male)*
Provide any food allergy information or special requests or accomodations that need to be made.