2024 Lost Canyon Wk 9

WHERE: Lost Canyon | Williams, AZ

WHEN: July 23-29, 2024

Departure: Tuesday, July 23, time TBD

Return: Monday, July 24, time TBD

COST: $800, a deposit of $150 is required to hold your spot.

Money is nonrefundable after 7/23/24.

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

Questions and Information

Contact at the Salida Young Life staff at:

Emily Grimes: (720) 217-8882; [email protected]

Jim LaCroix: (719) 221-4996; [email protected]

Participant Information

Summer 24

Lost Canyon

Guest Type

Registration Options

Register with a deposit or full payment ($800.00)
Please select to make a deposit or full payment below. Your card will not be immediately charged.
Register without a deposit ($800.00)

Participant Name

Date of Birth

Phone

Phone Type

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

Name

Phone

Phone Type

Address is same as participant

Address

Would you like to cover the 2.5% credit card processing fee?

Total (including 2.5% credit card processing fee)

$0.00

Billing Information

Name

Payment Method

Credit Card
Cash/Check

Credit Card

Visa
Mastercard
American Express
Discover

Address

Event Registration Software by RegFox