2024 Clearwater Cove Wk 6

WHERE: Clearwater Cove

WHEN: 2024-06-24 - 2024-06-28

Departure: June 24th, time will be announced soon.

Return: June 28th, time will be announced soon.

COST: $598, a deposit of $100 is required to hold your spot.

Money is nonrefundable after June 7th.

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:

120 S Broadway, Suite 216, Tyler, TX 75702

[email protected] (903) 526-0550

Participant Information

Guest Type

Are you bringing a child?

Registration Options

Register with a deposit or full payment ($598.00)
Please select to make a deposit or full payment below. Your card will not be immediately charged.
Register without a deposit ($598.00)

Participant Name

Date of Birth

Phone

Phone Type

Participant Address

Gender

Male
Female

Ethnicity

Other Languages Spoken

T-shirt Size

High School Graduation Year

Additional Comments

Parent / Guardian Information

Fill out the following parent/guardian information for the participant you are registering above.

Parent/Guardian Name

Parent/Guardian Phone

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Phone Type

Parent/Guardian Email

Address is same as participant

Parent/Guardian 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

Event Registration Software by RegFox