2024 Lost Canyon YoungLives Childcare Wk 4

WHERE: Lost Canyon Camp in Williams, AZ

WHEN: 03/23 to 06/28

Bus Travel Option Available:

Departure: 06/23 (time & location TBD)

Return: 06/28 (time & location TBD)

COST: $ 690, a deposit of $100

Money is nonrefundable after May 1, 2024.

After completing this form, a confirmation, health forms, and childcare training will be emailed.
Fundraising options are available.

Questions and Information

Contact the Young Life Merced Office at:

209-489-8557 Marissa Ramirez-Mussotto

[email protected]

Participant Information

Guest Type

Code

Code: Use code 2024Scholarship to sign up for fundraising.

Registration Options

Register with a deposit or full payment ($690.00)
Please select to make a deposit or full payment below. Your card will not be immediately charged. Monthly payment plans are available with a card.
Register without a deposit ($690.00)
Choose this option for cash/check payments or fundraising option.

Participant Name

Date of Birth

Phone

Phone Type

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

Participant Address

Gender

Male
Female

Ethnicity

T-shirt Size

Parent / Guardian Information

Please fill out if you are under 18 years of age. You will need consent to travel to camp and be supervised by a lead childcare volunteer over 18 years of age to participate.

Name

Phone

Phone Type

Address is same as participant

Address

Would you like to cover the 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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