Young Life Camp

WHERE: SOUTHWIND- A YOUNGLIFE CAMP OCKLAWAHA, FL

WHEN: January 31, 2025 - February 02, 2025

Departure: FRIDAY, JAN 31, 5:00PM

Return: SUNDAY, FEB 2, 3:00PM

COST: $189. A deposit of $50 is required to hold your spot.

Money is nonrefundable after NOVEMBER 15.

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

Questions and Information

Contact at the HALIFAX FL Young Life Office at:

DAWN HRYNKIW

561-714-7846

[email protected]

Participant Information

Guest Type

Registration Options

Register with a deposit OR full payment ($189.00)
Please select to make a deposit or full payment below. This will be paid by credit card.

Participant Name

Date of Birth

Phone

Phone Type

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

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

Parent/Guardian Email

Address is same as participant*

Address

Would you like to cover the 2.5% processing fee?

Total

$0.00

By filling out this form, you are opting in to Young Life communications.
In the future, you will be given the opportunity to manage your communication preferences.

Billing Information

Name

Payment Method

Credit Card
Cash/Check/Offline

Credit Card

Visa
Mastercard
American Express
Discover

Address

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