Summer 2025 Template

WHERE: Lake Champion (247 Mohican Lake Rd, Glen Spey, NY 12737)

WHEN: July 15, 2025 - July 20, 2025

Departure: Tuesday, July 15th Time and Location TBD

Return: Sunday, July 20th, Time and Location TBD

COST: $667 a deposit of $25 (Which is included in total) is required to hold your spot.

Money is nonrefundable after July 10th

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

Questions and Information

Contact Lily at the Young Life Office at:

470-799-8202 - [email protected]

Participant Information

Guest Type

Registration Options

Register with a deposit or full payment ($667.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Leader Registration ($0.00)
Please select if you are an approved Young Life St. Mary's Leader

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

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

Participant Information

Parent / Guardian Information

Billing Information