THE BEST WEEK OF YOUR LIFE!

WHERE: Southwind

WHEN: July 11th - July 15th

COST: $725. A deposit of $150 is required to hold your spot and is nonrefundable after May 1st. Balance is due by June 1st and is nonrefundable/nontransferable after that date.

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

Questions?

Contact the Young Life Office at:

[email protected] OR Jess Moore at (813) 523-5168

Participant Information

Guest Type

Registration Options

Camper ($725.00)
Please select to make a deposit or full payment below.
Leader ($0.00)

Participant Name

Date of Birth

Phone

Phone Type

Opt-in to receive email and text message communications.

You agree to Young Life's terms and privacy policy. Msg & Data rates may apply.

Participant Address

Gender

Male
Female

Additional Comment

Ethnicity

T-shirt Size

School

High School Graduation Year

Additional Comments

Parent / Guardian Information

Name

Phone

Phone Type

Address is same as participant

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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