Summer 2025 Template

WHERE: Southwind

WHEN: June 19, 2025 - June 23, 2025

Departure: Wednesday, June 18th

Return: Tuesday, June 24th

COST: $325, a nonrefundable deposit of $100 is required to hold your spot.

Money is nonrefundable after April 30th 2025.

Remaining balances are due by May 29th 2025.

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:

Trip Leader: Geneva Harper. Co-Trip Leader: Raymond Harper

Cell: 214-912-0426 Cell: 972-765-3784

E-mail: [email protected] E-mail: [email protected]

Metro Director: LaTonya Stevenson Cell: 214-536-2083

E-mail: [email protected]

Participant Information

Guest Type

Registration Options

Register with a deposit or full payment ($325.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment/$0 deposit ($325.00)
To register without credit card information, select cash/check/offline. This option will also create a payment link for the full balance listed.
Leader ($0.00)
A Young Life background checked adult.

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

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

Total

$0.00

Participant Information

Parent / Guardian Information

Billing Information