2024 Malibu Club Wk 3

WHERE: Malibu Club

WHEN: 2024-06-23 - 2024-07-01

Departure: Sunday, June 23rd, Time TBD (mid afternoon)

Return: Sunday, July 1st, Time TBD (also afternoon)

COST: $2600 , a deposit of $200 is required to hold your spot.

Money is nonrefundable after June 23rd.

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:

65 East Ave- Norwalk, CT 06851

513-658-7005- [email protected]

Participant Information

Guest Type

Registration Options

Register with just a deposit. ($2,600.00)
Please select below to make a deposit. You will be charged the remaining amount on date of departure.
Register without a deposit ($2,600.00)
Pay in full right now.
Register as leader ($0.00)

Participant Name

Date of Birth

Phone

Phone Type

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

Additional comment: This comment box can be used to gather any special circumstances related to gender that may impact housing at camp.

Ethnicity

T-shirt Size

School

High School Graduation Year

Additional comments: This comments box can be used to gather any special circumstances (need to leave camp early, received a $100 camp incentive, need to apply my unused deposit from last year because of a cancellation, etc).

Additional Comments

Parent / Guardian Information

Name

Phone

Phone Type

Address is same as participant

Address

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

Total

$0.00

Coupon Code

Billing Information

Name

Payment Method

Credit Card
Cash/Check

Credit Card

Visa
Mastercard
American Express
Discover

Address

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