Summer 2025 Template

Participant Information

Guest Type*

Leader or Camper*

Lost Canyon Leader

Registration Options*

Register with a deposit or full payment ($775.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment ($775.00)
You must have approval from Area Director Sarah Urban to register with this option, otherwise your spot will not be held.

Participant Name*

Date of Birth*

Participant 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*

Participant Email*

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*

Crewneck Size

School

High School Graduation Year*

Additional Comments

Parent / Guardian Information

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

Address*

Would you like to donate toward our scholarship fund to help send another student to camp?

Suggested Amounts

$100
$250
$500
$975
Other

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

Total

$0.00

Billing Information

Name*

Payment Method

Credit Card
Cash/Check/Offline

Credit Card*

Visa
Mastercard
American Express
Discover

Address*

Email*

Event Registration Software by RegFox