Men of Synergy Camp Registration

Men of Synergy Camp Registration Form

If you are human, leave this field blank.

MEN'S RETREAT REGISTRATION

First Name *

Last Name *

Address *

City *

State *

Zip *

Cell Phone *

Email Address

Age *

Home Church

Emergency Contact Person *

Emergency Contact Person Cell Phone *

Medical / Personal Notes

I relinquish New Life Church, Abba's Haven, volunteer workers and anyone associated therein of any liability while participating in all activities that are a part of this event. *

Pay *

$85 Online Now

$85 Cash Later (If the payment page appears, your submission was received and you can close the payment window.) CHECK YOUR "SPAM" FOLDER FOR EMAIL CONFIRMATION AFTER SUBMISSION.