Name* Email* CellCity Where You Live Company Role Training Dates Requested Intro PC (Co-Ed) | Date TBD Motivation for AttendingMassage (If we arrange for a Power Camp massage therapist to be onsite, would you be interested in receiving a massage? You will pay the therapist directly with a check or cash. $100 plus tip.) Yes No Will you be opening a PO? Yes No If you have the PO#, please enter it now (Otherwise you can email it to us at a later time) Would you like to pay with a credit card? Yes No Product Name PowerCamp Advanced Powecamp Total $0.00 Δ
