The Rally’s Got Talent Form

 

If you have any questions you may call TOLL FREE (800) 664-9145.

PLEASE UNDERSTAND THAT ACCEPTANCE OF THIS FORM IS SUBJECT TO APPROVAL.

Items below marked with an asterisk (*) are required.

1. Applicant Name(*)
2. Address(*)
3. City(*)
4. State/Province(*)
5. Zip/Postal Code(*)
6. Phone Number(*)
7. Cell Phone / Phone at Rally(*)
8. Rally Reservation Number(*)
9. Email Address(*)
10. Video Title as submitted to YouTube.com(*)
11. Type of Act
12. Individual Duet Group
13. If you answered Duet or Group above, include members' names below:
14. Member Names
15. Group Name
16. Brief Description(*)
17. I have read and agree to the Eligibilty Requirements & Right To Use Notice
18. Yes No
19. Please enter the verification code

 

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