2024 Lost Canyon Wk 4

WHERE: Lost Canyon, Williams, AZ

WHEN: June 24, 2024 - June 28, 2024

Departure: We will need to leave June 23rd if we drive

Return: We will return June 29th if we drive

COST: $598 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

Contact Kim D'Avis- YoungLives Coordinator

[email protected]

OR the Young Life Office at:

970-617-0608 - [email protected]

Participant Information

Guest Type: By default, we have listed options for Camper, Leader, and YoungLives Child. Refer to the Learning Guide to add other guest types to make sure they sync correctly to the Arrival Form in YL Connect.

Guest Type

Are you bringing a child?

If bringing a child, please be sure to register them separately right after you complete this registration.

Registration Options

Register with a deposit or full payment ($598.00)
Please select to make a deposit or full payment below. Your card will not be immediately charged.
Register without a deposit ($598.00)

Participant Name

Date of Birth

Phone

Phone Type

Participant Address

Gender

Male
Female

Ethnicity

Other Languages Spoken

T-shirt Size

High School Graduation Year

Additional Comments

Parent / Guardian Information

Fill out the following parent/guardian information for the participant you are registering above.

Parent/Guardian Name

Parent/Guardian Phone

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Phone Type

Parent/Guardian Email

Address is same as participant

Parent/Guardian Address

Would you like to cover the 2.5% credit card processing fee?

Total

$0.00

Billing Information

Name

Payment Method

Credit Card
Cash/Check

Credit Card

Visa
Mastercard
American Express
Discover

Address

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