Summer 2025 Template

WHERE: Clearwater Cove Lampe, MO

WHEN: June 20, 2025 - June 24, 2025

COST: $ 825, a deposit of $ 100 is required to hold your spot.

Money is nonrefundable after 3-25-25.

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

Questions and Information

Registration or payment questions please contact Lori Hartline at the Young Life Office at 316-303-1490 or [email protected]..

Ministry or camp trip related questions please contact Caleb Zweerink at 816-344-6909 or [email protected].

Participant Information

Registration Options

Middle School Camper Registration ($825.00)
Leader Registration ($0.00)

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

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