M3 Man Camp INDIVIDUAL Registration

August 11-13, 2022
Location: Country Lake Christian Retreat | 815 Country Lake Road | Underwood, IN 47177
www.countrylake.org

Cost: $99 by July 1st | $115 after

Registration includes all meals, after service snacks and Friday Fun Day activities
Church Name
District
Name of Registrant Name of Registrant First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email
Phone Phone - ### - ### ####
Signature

Draw or Type

By signing this form I understand that I am reserving my spot at M3 Man Camp - once I have paid in full. I understand the registration fee and will complete payment via check/cash. I understand that registration is limited, and this form only reserves my spot upon full payment. Clear

Full Name

By signing this form I understand that I am reserving my spot at M3 Man Camp - once I have paid in full. I understand the registration fee and will complete payment via check/cash. I understand that registration is limited, and this form only reserves my spot upon full payment.
Payment Info:
Please mail registration fee to:

M3
c/o Jimmy Patillo
PO Box 1689
Frankfort, KY 40602