Summer 2025 Template

WHERE: Southwind- Ocklawaha, FL

WHEN: June 13- June 17, 2025

Departure: Friday, June 13 5:45pm

Return: Tuesday, June 17 2:00pm

COST: $600

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

Money is nonrefundable after May 1, 2025.

Please contact your local Younglife Area Director for Camp Scholarship information. After completing this form, a confirmation will be sent with the information you have entered below.

Questions and Information:

Contact Halifax Area Young Life

Dawn Hrynkiw

561-714-7846

dawn.hrynkiw@gmail.com

Participant Information

Guest Type

Registration Options

Register with a DEPOSIT or FULL PAYMENT ($600.00)
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

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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

Billing Information

Name

Payment Method

Credit Card
Cash/Check/Offline

Credit Card

Visa
Mastercard
American Express
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Address

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