Participant Information

Registration Options

Register with a deposit or full payment ($275.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Pay offline payment/$50 Credit Card Deposit Due Now ($275.00)
Deposit is due with credit card but the rest of the payment you can select cash/check/offline. This option will also create a payment link for the full balance listed.

Guest Type

Participant Name

Date of Birth

Phone

Phone Type

Parents Email

Participant Address

Gender

Male
Female

Additional Comment

Ethnicity

School

High School Graduation Year

Will your child need to take medication while at camp?

Parent / Guardian Information

Parent/Guardian Name

Parent/Guardian Phone

Yes, it's okay to send me text messages including order confirmations, updates, event reminders, and event information. Message frequency varies. Message and data rates may apply. Reply HELP for help, STOP to cancel. View our terms of service & privacy policy.

Phone Type

Parent/Guardian Email

Address is same as participant

Address

Would you like to cover the 2.5% processing fee?

Total

$0.00

By filling out this form, you are opting in to Young Life communications.
In the future, you will be given the opportunity to manage your communication preferences.

Billing Information

Secure checkout PCI compliant

Name

Payment Method

Credit Card
Cash/Check/Offline

Credit CardSecure Payment

Address

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Wyldlife Fall Camp

Participant Information

Parent / Guardian Information

Billing Information