Young Life Fall Weekend Camp

Participant Information

Guest Type

Scholarship Form Request

Registration Options

Register with a deposit or full payment ($195.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment | Paying $50 deposit ($195.00)
Register with an offline payment | No Deposit Payment at this time ($195.00)
To register without credit card information, select cash/check/offline. This option will also create a payment link for the full balance listed.
Leader & Staff Registration ($0.00)

Participant Name

Date of Birth

Phone

Phone Type

Participant Address

Gender

Male
Female

Dietary Needs

Ethnicity

Young Life Club

Current Grade

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

Would you like to cover the 2.5% processing fee?

Total

$0.00

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In the future, you will be given the opportunity to manage your communication preferences.

Participant Information

Parent / Guardian Information

Billing Information