Mind Games Camp 2021 Online Registration Student's Name First Last Parent's Name First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Student Cell PhoneParent PhoneParent Email Student Email Age on June 13. 2021BirthdateGenderMaleFemaleSchoolChurchStudent's Preferred Name for NametagHow Did You Hear About Mind Games?Register with Credit Card or by MailRegistration - $495Registration Plus Ropes Course - $520Alumni Registration - $425Alumni Registration Plus Ropes Course - $450Scholarship offset - $200Add Ropes Course - $25Register By MailCredit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Register Without Paying OnlineRegistration - $495Registration plus Ropes Course - $520Alumni Registration - $425Alumni Registration plus Ropes Course - $450Register your student online but mail your check to the Probe office: Probe Mind Games 2001 W. Plano Parkway, Suite 2000 Plano TX 75075
