Capernaum "Fun Life" 2012 Summer Camp Registration Form
Capernaum "Fun Life" 2012 Summer Camp Trip
Dates: July 1-6
Location: Lost Canyon - Williams, AZ (30mi west of Flagstaff)
Price: $700

Please fill out the below form and send in your $100 non-refundable deposit (checks payable to Young Life - note camper's name & "Lost Canyon" in memo line) to Capernaum Director at:  Amy Nielsen, Young Life Greater Pasadena, 3916 Park Place, Montrose 91020

** Final Camp Balance must be postmarked by June 20th**

Questions:

Contact Amy Nielsen, Capernaum Director - Email: amy@greaterpasadena.younglife.org; Cell: (818) 216-8682

www.greaterpasadena.younglife.org, www.lostcanyon.younglife.org
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First Name *
Last Name *
Address *
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Zip Code *
Email Address (Student)
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Parent(s)/ Guardian First & Last Name(s) *
Email Address (Parent/ Guardian) *
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I am mailing my non-refundable $100 deposit check to hold my spot for camp within 5 days of registering online. *
Please make checks payable to "Young Life" and send to: Amy Nielsen, Young Life Greater Pasadena - 3916 Park Place,  Montrose  CA  91020.  Please note camper's name & "Lost Canyon" in the memo line.
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