Discover Youth Rally
Individual Registration

Name

Church

Address

City

State       Zip Code

Phone

Email

Grade in School

Tshirt Size (check below)
Adult Small Adult Medium  Adult Large 

Adult XLarge Adult XXL  Adult XXXL

Housing Needed for Friday? (check below)
Yes    No 

Housing Needed for Saturday? (check below)
Yes    No 

Football Ticket for MSU vs. Tennessee Martin

Yes No

If Registering before October 3rd- Registration without football ticket is $15.  Registration with football ticket is $25

If Registering after October 3rd- Registration without football ticket is $20.  Registration with football ticket is $30.

Make check to Starkville church of Christ and mail to

Starkville church of Christ
Discover Youth Rally
613 East Lee BLVD.
Starkville MS, 39760.

Enter the numbers as they
are shown in the image above

Registration is not complete until your check is received!