Summer 2025 YoungLives Template

WHERE: Lost Canyon

WHEN: June 24 - June 28, 2025

Departure: Tuesday, 6/24/2025 -- 6:00am

Return: Saturday, 6/25/2025 -- 9:00pm

COST: $0 - We cover the cost!

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

Questions and Information

Contact our Staff:

Chelsea Montgomery

(310) 427-4890 - chelseamonty19@gmail.com

Participant Information

Guest Type

Are you bringing a child?

Participant Name

Date of Birth

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 Address

Gender

Male
Female

Ethnicity

Other Languages Spoken

T-shirt Size

High School Graduation Year

Additional Comments

Parent / Guardian Information

Fill out the following parent/guardian information for the participant you are registering above.

Parent/Guardian Name

Parent/Guardian Phone

Phone Type

Parent/Guardian Email

Address is same as participant

Parent/Guardian Address

Total

$0.00

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In the future, you will be given the opportunity to manage your communication preferences.

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Name

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