2024 Southwind Wk 10 - GA63

WYLDLIFE LAGRANGE

SOUTHWIND JULY 11-15

WHERE: Southwind

WHEN: 2024-07-11 - 2024-07-15

Departure: Thursday, July 11

Return: Monday, July 15

COST: $ 755, a deposit of $ 150 is required to hold your spot.

Money is nonrefundable after March 1st.

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:

Rose Rockecharlie

770-865-1924 or [email protected]

Participant Information

Guest Type*

Southwind 2024*

Southwind 2024

Registration Options*

Register with a deposit or full payment ($755.00)
Please select to make a deposit or full payment below.
Register without a deposit ($755.00)
Leader ($400.00)

Participant Name*

Date of Birth*

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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

Grade

Any dietary restrictions/allergies?

Parent / Guardian Information

Name*

Phone*

Phone Type*

Email*

Address is same as participant

Address*

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

Total

$0.00

Billing Information

Name*

Payment Method

Credit Card
Cash/Check

Credit Card*

Visa
Mastercard
American Express
Discover

Address*

Email*

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