Captain Signup Form

Personal Information:
Title *
First Name *
Last Name *
Address *
Address2
City *
State *
Zip Code *
Country *
Home Phone Number
Email Address *
Confirm Email Address *
What do you need for your Rally:

Banners and Manuals will be sent starting in August and no more Banners and Manuals will be sent after October 4th.
- Banner and Manual
- Manual Only
- No Banner or Manual - I will use my Banner from last year and download the Manual when it becomes available in August
Phone Publication *
- Allow
- Disallow
Rally Material Language *
- English
- Spanish

Rally Location Information: (Optional)
Attention: If you already know where you will hold your rally, please use this part of the form to tell us about it. By providing the address of your Rally, you will allow us to display your Rally location on our site so others can join your rally.
Important: This part of the form is totally optional, you can skip it by pressing the SUBMIT button at the bottom.
Captain Name
Contact Phone Number
Rally Name
Rally City
Rally State
Rally Zip Code
Rally Country
Rally Address
Rally Address Description
Exact Location to be determined
For assistance, please call our Rosary Rally Hotline on (866) 584-6012

Rosary Rally Sign Ups : 5050

Goal : 20000