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Our youth rally will be held Saturday, November 13, 2021 from 10am-4pm at Northwest Georgia Amphitheatre.

Full Name (first & last) *

Age *

Grade 6

Grade 7

Grade 8

Grade 9

Grade 10

Grade 11

Grade 12

College

Adult

Child (grades 5 & below must be accompanied by an adult)

Will you be able to stay for the entire event?

Yes! 10am-4pm

Morning only

Afternoon only

Clear selection

Will you be eating the provided lunch (Chick Fil-A sandwich, chips and drink)? *

Of course!

No, I won't be able to be there at noon for lunch

No, I don't like that food option, so I'll bring my own meal

Do you prefer your Chick Fil-A sandwich WITH or WITHOUT pickles?

WITH pickles

WITHOUT pickles

Not eating lunch

Clear selection

Are you interested in performing in an open-mic "talent show" during the lunch break? This will only happen if there's enough interest. You'd have 5 minutes (or less), a stage, a microphone, and a halfway-attentive crowd of teens eating chicken sandwiches and talking to their long-lost friends with their mouths full. If you're interested, describe below what you're interested in doing for the show (song lyrics need to be approved).

Phone number where any important event updates can be texted, if needed.

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