Young Life Camp

WHERE: Southwind

WHEN: November 22, 2024 - November 24, 2024

Departure: Friday, November 22nd at 5:00pm from Young Life Club Room Parking Lot (4908 Lena Rd)

Return: Sunday, November 24th around 3:30pm

COST: $250 a deposit of $100 is required to hold your spot.

After completing this form, a confirmation will be sent with the information you have entered below.

Questions and Information

Email: [email protected]

Participant Information

Guest Type

Fall Camp

Southwind 2024 [Join Waitlist]

Registration Options

Register with a deposit or full payment ($250.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment/$0 Deposit ($250.00)
To register without credit card information, select cash/check/offline. This option will also create a payment link for the full balance listed.

Participant Name

Date of Birth

Phone

Phone Type

Participant Address

Gender

Male
Female

Additional Comment

Ethnicity

T-shirt Size

School

High School Graduation Year

Additional Comments

Parent / Guardian Information

Parent/Guardian Name

Parent/Guardian Phone

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Phone Type

Parent/Guardian Email

Address is same as participant*

Address

Total

$0.00

Billing Information

Name

Payment Method

Credit Card
Cash/Check/Offline

Credit Card

Visa
Mastercard
American Express
Discover

Address

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