2015 Silicon Valley Young Life Camp Registration Form (Area # CA18)

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Choose Camp Below: *

Middle School Oakridge Summer Camp: July 21-25

Young Life Adventures: August 2-7

Camper's First Name *

Camper's Last Name *

Camper's Gender *

Camper's Grade *

Enter grade for 2014-2015 school year

What school does the camper attend? *

Camper's T-Shirt Size *

Based on Adult Size Shirt

Street Address *

City *

Zip Code *

Camper's Cell Phone *

Enter "none" if they don't have one

What is the first and last name of the Primary Contact? *

This is the parent/guardian we will communicate with regarding important camp information.

Is the phone number provided *

Primary Contact's Phone Number *

Primary Contact's Email *

Enter "None" if they do not have one

AFTER submitting this Registration Form by clicking below, proceed to Step #2 to make your online, non-refundable/non-transferable deposit. *

Your registration is NOT complete until we have received BOTH this Registration Form and non-refundable/non-transferable deposit. The Registration Form and payment are two separate steps. You may pay online or mail a check to the YL office (1320 Lincoln Avenue San Jose, CA 95125). Your camper's registration will NOT be complete until payment is received. How will you make your deposit?

Questions or Comments?

Payment Options:

Please select the options.

I will make 1 full payment

I will make an initial deposit and 1 payment

I will make a payment and my child will need to fundraise.

I wil make a deposit and four payments

Other:

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