Summer 2025 Template

WHERE: Lost Canyon Young Life Camp

1450 S Perkinsville Rd. Williams, AZ 86046

WHEN: July 17, 2025 - July 22, 2025

Departure: Thursday July 17th @ 6:30 am

Return: Tuesday July 22nd (estimated late evening).

COST: $799, a deposit of $100 is required to hold your spot.

$100 deposit is nonrefundable after April 1st.

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

Questions and Information

Contact for Grand Valley Young Life:

[email protected]

(970) 243-7684

Participant Information

Guest Type

Registration Options

Register with a deposit or full payment ($799.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment/$0 deposit ($799.00)
To register without credit card information, select cash/check/offline. This option will also create a payment link for the full balance listed.

Lost Canyon

2025

Participant Name

Date of Birth

Participant Phone

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. Reply STOP to cancel. 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 or Young Life Club

High School Graduation Year

Please List: Any Special Accommodations/ Allergies? /Dietary Restrictions?

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