Summer 2025 Template

WHERE: Clearwater Cove Lampe, MO

WHEN: June 20, 2025 - June 24, 2025

COST: $ 699

A deposit of $ 100 is required to hold your spot.

$225 due by 3/25/25.

The remaining balance of $374 due by 6/6/25. Fundraising opportunities are available.

Money is nonrefundable after March 25, 2025

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

Questions and Information

Registaration or payment questions please contact Lori Hartline at the Young Life Office at 316-303-1490 or [email protected]..

Ministry or camp trip related questions please contact Katie Alexander at 316-880-0209 or [email protected]

Participant Information

RegistrationType

Registration Options

Student Registration ($699.00)
Leader Registration ($0.00)

Participant Name

Date of Birth

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 (Adult Size)

Current Grade for the 2024-2025 School Year

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 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

Event Registration Software by RegFox