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Contact information
Young Life Summer Camp Sign-up
* Indicates required question
Email
*
Your email
Camper Name
*
Your answer
Camper Phone Number
*
Your answer
Gender
*
Male
Female
Guardian/Parent Name
*
Your answer
Address
*
Your answer
City, State, Zip
*
Your answer
Phone number
*
Your answer
School Student Attending
*
Your answer
Current Grade
*
Choose
9th
10th
11th
12th
T-shirt Size
*
Small
Medium
Large
XL
XXL
Would you like more info about Fundraising Options?
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Yes
No
How would you like to pay for deposit of $99
*
Pay Online at
centraljeffco.younglife.org
(select the camp from camp tabs up top)
Send Check to our PO Box 601 16th St. Suite C, #203
I or my student will give a check to a Young Life leader
Special Dietary Needs??
Your answer
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