Entry Deadline September 23, 2011 

26th Annual Rebel Invitational

Saturday, October 15, 2011

Just complete this form. Print a copy or two for yourself before submitting. Click on Submit when ready to send. Make Checks Payable to Central Band Boosters. Send to Brad Glore, Central High School, 116 Rebel Drive, Park Hills, MO 63601

Name:
Email Address:
Check Area of Participation	Field Entry = $200
School Name
School Address
City, State Zip
Telephone
Fax
Band Nickname
School Colors
Mascot
Director's Name
Home Telephone
Email Address
School Enrollment
Number in Band
Number of Buses
Number of Equipment Vehicles
Asst. Director's Name(s)
Additional Staff Names