Thank you for committing to your personal power and growth by trusting a man to participate in our
2018 Men’s Remarkable Tribute Weekend. Your information below is 100% confidential.
Your answer
Registration Details:
JANUARY 26 / 27 / 28, 2018 / Friday 3pm sharp to Sunday 12pm sharp.

Leadership Facilitation, heated cabins, all meals, facilities, and impeccable care.

The Men’s Tribute Weekend is $475 prior to January 15, 2018, payable through PayPal. [ $550 thereafter ]
To pay :

You will be sent complete detailed instructions for your preparation and full participation.

*Paid in full by JANUARY, to take advantage of the early registration fee.
* If not, payment of $550 must be received by January 20th, to complete your full registration.

Trust the man who is helping you get here.

Last Name
Your answer
Your answer
Your answer
Your answer
Your answer
Your answer
Your answer
My Sponsor
The Man I trusted for helping me attend my weekend.
Your answer
My Sponsor's Cell Phone #
Your answer
My Main Purpose For Attending This Weekend Is:
Your answer
My Commitment:
Mailing list
Weekend Release
Participant’s Participating Release Form: MEN'S TRIBUTE WEEKED 2018
The Remarkable Men's Practice • A Coach In Your Corner • 2258 Thirty First Street • Studio One • Santa Monica 90405

I [Full Name Entered Below] referred to as “Releasor,” and the Remarkable Men's Practice and
the Santa Monica MensCircle, Paul Bob Velick, its representatives, and all owners, agents,
hosts and individualsattached to the Mens Tribute event located at NEW 2018 SITE,CA,
hereinafter collectively referred to as “Re-leasees,” in consideration of the descriptions herein,
agree as follows: Releasor acknowl-edges that he has been given the opportunity to participate
in a Mens Tribute Weekend Event.

Releasor, on behalf of himself, his heirs, executors, administrators, and assignors, hereby
fully releases releasees, their successors, and all other persons and associations, known
or unknown, from all claims and causes of action by reason of any physical action, phys-
ical injury, injury and/or damage which may be sustained, as a result of Releasor’s partic-
ipation in this Mens Tribute 2018. Releasor acknowledges and agrees that this release
applies to all claims that Releasor may have against releasees arising out of Releasor’s
participation in the Mens Tribute for injuries, damages, or losses to Releasor’s person or
property, real or personal, whether those injuries, damages, or losses are known or un-
known, foreseen or unforeseen, patent or latent, Releasor holds Releasee harmless of
any/all claims and responsibilities or actions.

Releasor represents that in signing this release, he has had the opportunity to understand
the terms of this release. Releasor acknowledges and represents that he has been ap-
prised of all relevant information and data relevant to this release, including, without limi-
tation, future risks, complications, and costs. Releasor further acknowledges and
represents that, in executing this release, he has not relied on any inducements, promises,
or representations made by releasees or any party representing or serving releasees. Re-
leasor acknowledges that his execution of this release is free and voluntary.

Your Full Name
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms