Discipleship Camp

WHERE: Plenty Rocks Ranch, Cody Wyoming

WHEN: June 09, 2024 - June 14, 2024

COST: $250, a deposit of $50 is required to hold your spot.

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:

[email protected] - (406) 665-7351

618 Main St. Suite 201, Lewistown, MT, 59457

Participant Information

Guest Type

Discipleship Camp

Plenty Rocks Ranch

Registration Options

Participant Name

Date of Birth

Phone

Phone Type

Participant Address

Gender

Male
Female

Additional Comment

Ethnicity

T-shirt Size

School

High School Graduation Year

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% 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

Name

Payment Method

Credit Card
Cash/Check

Credit Card

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American Express
Discover

Address

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