Summer 2025 Template

WHERE: Southwind YL Camp 18115 SE 95th Street Rd, Ocklawaha, FL 32179

WHEN:

June 23, 2025 - June 28, 2025

Departure: June 23, 2025

Return: June 28, 2025

COST: $ 850, a deposit of $ 250 is required to hold your spot.

Money is nonrefundable after April 31, 2025

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

Questions and Information

Contact at the Young Life Office at:

828 263 4111

[email protected]

Participant Information

Guest Type

Registration Options

Register with a deposit or full payment ($850.00)
Please select to make a deposit or full payment below. This will be paid by credit card.

Participant Name

Date of Birth

Participant Phone

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. 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

T-shirt Size

School

High School Graduation Year

Additional Comments

Parent / Guardian Information

Parent/Guardian Name

Parent/Guardian Phone

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

Coupon Code

Billing Information

Name

Payment Method

Credit Card
Cash/Check/Offline

Credit Card

Visa
Mastercard
American Express
Discover

Address

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