Summer 2025 Template

WHERE: Lake Champion

WHEN: July 22, 2025 - July 26, 2025

Departure: Tuesday, July 22nd at 8:30am | Baliwick's 441 NY-5, Elbridge

Return: Saturday, July 26th around 6:00pm | Baliwick's 441 NY-5, Elbridge

COST: $ 585, a deposit of $ 50 is required to hold your spot.

Money is nonrefundable after May 1st.

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:

Chris Hammersley | [email protected]

Participant Information

Guest Type

Camper
Leader

Registration Options

Register with a deposit or full payment ($585.00)
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

Participant Information

Parent / Guardian Information

Billing Information