2012 Mens Conference Registration

Date:	February 24th and 25th
Location:	Mahoney State Park (Nebraska)
Accomodations:	Mahoney State Park Lodge or Cabins, all rooms double occupancy
Cost:	$75 if paid by January 15th, $95 if paid after January 15

Note: Your payment for the weekend should be given to John Widhalm or dropped in the slot of the locked offering box mounted on the wall behind the kitchen door. Be sure to put "MAN-CAMP Registration" in the memo area of your check or on your envelope.

First and Last Name *
Street Address *
City *
State *
Zip Code *
Phone Number *
E-Mail Address *
Home Church: *
Roommate Preference
I am interested in helping with the conference in the following areas	Registration Check-In Kitchen Help Wherever Needed
Comments (if you desire a single occupancy room let us know and we'll get back to you with the cost)
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