Registration "*" indicates required fields Women's Camp Price: Preregistrations paid by December 31, 2024 receive a $100 discount.Accommodations* I will stay at camp in a bunk with other campers. (no additional cost) I prefer to stay off-camp at the Holiday Inn Express Martinsville. I will be commuting home each night. I prefer to stay off-camp at the Holiday Inn Express Martinsville.* Monday night Tuesday night We have 20 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* Payment 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 Card Holder* Card Number* Card Expiration* Card CVV* Total CheckCheck must be received by Mickey’s Camp prior to December 31, 2024 to receive the $100 discount. Please 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 46202-3850Total