Summer 2025 Template

WHERE: B.C. Canada

WHEN: August 06, 2025 - August 15, 2025

Departure: Wednesday, August 6th at approx. 6AM

Return: Friday, August 15th at approx. 8PM

COST: $1100, a deposit of $100 is required to hold your spot.

Deposits are nonrefundable upon registration.

All other money in your account is nonrefundable after April 1st.

Any fundraised money will be kept with that camp spot if you choose to drop the spot.

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

Questions and Information

Contact at the Lindsey Mode:

Crook County Young Life, PO Box 1983, Prineville, OR 97754

541-903-2414 | [email protected]

Participant Information

Guest Type

Summer 2025

Beyond Malibu Week 12

Registration Options

Register with a credit card ($1,100.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with cash/check ($1,100.00)
To register without credit card information, select cash/check/offline. This option will also create a payment link for the full balance listed.

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

College attending or job you work?

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