Registration "*" indicates required fields Men's Camp Price: Accommodations* I will stay at camp in a bunk with other campers. (no additional cost) I prefer to stay off-camp at the My Hometown Inn, Mooresville I will be commuting home each night. I prefer to stay off-camp at the My Hometown Inn, Mooresville. Wednesday night Thursday night We have 35 rooms in our hotel room block. They will be filled on a first-come first-serve basis.Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Company/Organization*How many years have you attended camp (counting this year)?:*Please enter a number from 1 to 25.T-shirt sizeMLXLXXL3XLEmergency Contact Name (not yourself)*Emergency Contact Cell (not yourself)*Dietary RestrictionsAllergies*Is this allergy life threatening?*N/AYesNoActivity SelectionSelect activities in order of preference (1st, 2nd and 3rd choice) for each time period.Interested in coming early on Wednesday?*NoHeavy MachineryRifle & PistolShotgunDepending on availability you may attend one session before lunch with the women in their 10:30 a.m. session.Wednesday, Aug. 19 – 1:30-3 p.m.1st Choice*Select OneDecline ActivityAnatomy of a Wrongful ConvictionArcheryCheese & WineEntrepreneurship with Scott DorseyHeavy MachineryMassagePickleballPro Football Talk with Ryan DiemRifle & PistolSelf DefenseShotgunSushi & SakeWorld of Watches with Moyer Fine Jewelers2nd Choice*Select OneDecline ActivityAnatomy of a Wrongful ConvictionArcheryCheese & WineEntrepreneurship with Scott DorseyHeavy MachineryMassagePickleballPro Football Talk with Ryan DiemRifle & PistolSelf DefenseShotgunSushi & SakeWorld of Watches with Moyer Fine Jewelers3rd Choice*Select OneDecline ActivityAnatomy of a Wrongful ConvictionArcheryCheese & WineEntrepreneurship with Scott DorseyHeavy MachineryMassagePickleballPro Football Talk with Ryan DiemRifle & PistolSelf DefenseShotgunSushi & SakeWorld of Watches with Moyer Fine JewelersWednesday, Aug. 19 – 3:30-5 p.m.1st Choice*Select OneDecline ActivityCanoeingHeavy MachinerySelf DefenseShotgun2nd Choice*Select OneDecline ActivityCanoeingHeavy MachinerySelf DefenseShotgun3rd Choice*Select OneDecline ActivityCanoeingHeavy MachinerySelf DefenseShotgun8:15 p.m. Nefouse Memorial Poker TournamentNoYes8:15 p.m. Paracord Bracelet MakingNoYesThursday, Aug. 20 – 8:30-10 a.m.1st Choice*Select OneDecline ActivityBook Chat: Top PicksChanging Indy's Skyline & MoreCooking w/ Chef RickyGolfMassageNature Hike – BirdsPersonal Health & AgingPoliticsRifle & PistolShotgunTomahawkYomassage2nd Choice*Select OneDecline ActivityBook Chat: Top PicksChanging Indy's Skyline & MoreCooking w/ Chef RickyGolfMassageNature Hike – BirdsPersonal Health & AgingPoliticsRifle & PistolShotgunTomahawkYomassage3rd Choice*Select OneDecline ActivityBook Chat: Top PicksChanging Indy's Skyline & MoreCooking w/ Chef RickyGolfMassageNature Hike – BirdsPersonal Health & AgingPoliticsRifle & PistolShotgunTomahawkYomassageThursday, Aug. 20 – 10:30 a.m.-Noon1st Choice*Select OneDecline ActivityAI & LeadershipBook Chat: Top PicksChanging Indy's Skyline & MoreCooking w/ Chef RickyFly FishingGolfMassageMedia: Ask the EditorNature Hike – BirdsPersonal Health & AgingRifle & PistolShotgunStand Up PaddleboardTomahawkWatersports FunYomassage2nd Choice*Select OneDecline ActivityAI & LeadershipBook Chat: Top PicksChanging Indy's Skyline & MoreCooking w/ Chef RickyFly FishingGolfMassageMedia: Ask the EditorNature Hike – BirdsPersonal Health & AgingRifle & PistolShotgunStand Up PaddleboardTomahawkWatersports FunYomassage3rd Choice*Select OneDecline ActivityAI & LeadershipBook Chat: Top PicksChanging Indy's Skyline & MoreCooking w/ Chef RickyFly FishingGolfMassageMedia: Ask the EditorNature Hike – BirdsPersonal Health & AgingRifle & PistolShotgunStand Up PaddleboardTomahawkWatersports FunYomassageThursday, Aug. 20 – 1:30-3 p.m.1st Choice*Select OneDecline ActivityBeyond WealthBourbon TastingFacialsMassageRifle & PistolShotgunStand Up PaddleboardTequila TastingTomahawkWatersports FunZipline2nd Choice*Select OneDecline ActivityBeyond WealthBourbon TastingFacialsMassageRifle & PistolShotgunStand Up PaddleboardTequila TastingTomahawkWatersports FunZipline3rd Choice*Select OneDecline ActivityBeyond WealthBourbon TastingFacialsMassageRifle & PistolShotgunStand Up PaddleboardTequila TastingTomahawkWatersports FunZiplineThursday, Aug. 20 – 3:30-5 p.m.1st Choice*Select OneDecline ActivityBeyond WealthRifle & PistolShotgunStand Up PaddleboardTequila TastingTomahawkWatersports FunZipline2nd Choice*Select OneDecline ActivityBeyond WealthRifle & PistolShotgunStand Up PaddleboardTequila TastingTomahawkWatersports FunZipline3rd Choice*Select OneDecline ActivityBeyond WealthRifle & PistolShotgunStand Up PaddleboardTequila TastingTomahawkWatersports FunZipline8:30 p.m. Euchre Tournament*NoYesThis field is hidden when viewing the form8:30 p.m. Wine Tasting with RNDC*NoYesFriday, Aug. 21 – 9:00-10:30 a.m.1st Choice*Select OneDecline ActivityInternational Interventions in Failing StatesiPhone PhotographyNature Hike – TreesRifle & PistolShotgun2nd Choice*Select OneDecline ActivityInternational Interventions in Failing StatesiPhone PhotographyNature Hike – TreesRifle & PistolShotgun3rd Choice*Select OneDecline ActivityInternational Interventions in Failing StatesiPhone PhotographyNature Hike – TreesRifle & PistolShotgunPayment InformationPayment TypeCredit CardCheckCredit CardBilling Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Credit Card Payment Card Holder* Card Number* Card Expiration* Card CVV* CheckPlease include a copy of your registration, that will be emailed to you, with your check. Make check payable to Mickey’s Camp and send to: Kari Strolberg Mickey’s Camp 1336 E. Washington Street Indianapolis, IN 46202-3850This field is hidden when viewing the formTotalTotal
