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MHSAA/MBA State Marching Championship Declaration Form
Declaration Form for State Marching Championship. This form is not valid until your fee has been received.
The Registration Fee is $250. The Registration Fee should be sent with a print out of this form. Bands not selected for the Championship will receive a refund for the Registration Fee. The Declaration Form and Registration Fee must be received by September 15.

Make Checks payable to: Mississippi Bandmasters Association.

Due by: September 15

Mail To:

Len Killough
1st Vice President, MBA
805 Dilworth Lane
Hernando, MS 38632

Email: lenkillough@yahoo.com

School Name *
Your answer
Band Name *
Your answer
Region Attended: *
Choose the Region that you attended for State Marching Evaluation
Band Director(s): *
Your answer
Other Directors:
Your answer
Additional Staff:
Your answer
Name of School Principal: *
Your answer
Name of District Superintendent: *
Your answer
School Address: *
Your answer
City: *
Your answer
Zip Code: *
Your answer
School Phone: *
Your answer
Director's Home Phone: *
Your answer
Director's Cell Phone: *
Your answer
Director's email: *
Email is a primary communication tool and this address must accept attachments.
Your answer
Alternate Email Address:
Your answer
Fax Number:
Your answer
School Classification: *
School Enrollment: *
Your answer
Total Band Students, Including Auxiliaries: *
Your answer
Total Band Helpers (Must be dressed in uniformed clothing): *
Your answer
Program/Show Title and Selections: *
Your answer
Drum Major(s): *
Your answer
Number of Buses You will Bring: *
Your answer
Type of Buses: *
Number of Equipment Vehicles You Will Bring: *
Your answer
Type of Equipment Vehicles You Will Bring: *
Is your band interested in placing a group meal order with the host site?
Declaration Statement:
Our band will participate in the MHSAA/MBA State Marching Band Championship if selected from the Regional Marching Festivals. I understand that if our band drops out of the Championship after October 1st, a $250 fine will be imposed and our band will not be allowed to participate in the Championship the following year.
By checking below I acknowledge that I have read and agree to the above statement. *
Required
Registration Fee: $250
The Registration Fee should be sent with a print out of this form. Bands not selected for the Championship will receive a refund for the Registration Fee. The Declaration Form and Registration Fee must be received by September 15. Make Checks payable to: Mississippi Bandmasters Association.

Due by: September 15

Mail To:

Len Killough
1st Vice President, MBA
805 Dilworth Lane
Hernando, MS 38632

Email: lenkillough@yahoo.com

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