Reality Rally 2018 Star Sign Up Form
Thank you for your interest in Reality Rally - Michelle's Place Breast Cancer Resource Center helps others because of you! Once you fill out the form Lily Holland, Celebrity Relations, Executive Director will be contacting you by email within 48 hours. Please add Lily@realityrally.com to your contacts. Thank you for supporting Michelle's Place Breast Cancer Resource Center.
First Name *
Name you would like to be seen on the Reality Rally Website, your fundraising page and printed materials.
Your answer
Last Name *
Name you would like to be seen on the Reality Rally Website, your fundraising page and printed materials.
Your answer
Reality Show *
Name of the Reality Show you were on. Ex: Survivor Gabon
Your answer
Season *
Which season were you on. Ex: 17
Your answer
Reality Rally Star Attendance (Check all years that apply) *
Please check the 2018 box if your attendance is less than All 8 years. All 8 years need only check the top box.
Required
Which option would you like to sign up with? (Choose one) *
DISTANT STAR DEFINITION - Traveling OVER 3.5 hours to Temecula. LOCAL STAR DEFINITION - Traveling 3.5 or LESS hours to Temecula
Required
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Age Range *
Email Address *
Your answer
Cell Phone Number *
Area code and #
Your answer
Best way to contact you? *
How did you hear about Reality Rally? *
Reality Rally "Amazing Race Type Game" (Choose one) *
PLEASE READ: All stars will be a part of the Saturday morning Event - "Amazing Race type Game" you have 2 options. To play "The Game" and be the star on a team with 3 fans OR be a "Checkpoint Star" you are not physically able to play "The Game" instead you will be at one of the checkpoints and cheer teams as they come in.
T-Shirt Size *
All your Official Social Media Names *
Facebook name, @Twitter, @Instagram, etc (please give full information, not a yes or no answer)
Your answer
Dietary Restrictions (We can't promise, but do try) *
All meals and snacks are sponsored for Reality Rally. We can't promise any particular food items but we do realize some have dietary restrictions and if possible we will make an effort to bring sponsors on board that may be able to accommodate some dietary restrictions. Again, please understand this is not a guarantee.
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