ADULT GUEST REGISTRATION

THE ADULT GUEST OR AN AREA STAFF PERSON MAY COMPLETE THIS REGISTRATION FORM TO REGISTER FOR A STAY AT A YOUNG LIFE CAMP. WHEN COMPLETE, MAIL WITH A REGISTRATION DEPOSIT EQUAL TO 50% OF THE TOTAL CHARGE FOR THE LENGTH OF YOUR VISIT TO THE AREA DIRECTOR OR REGIONAL DIRECTOR WHO WILL THEN FORWARD IT TO THE CAMP. DEPOSITS ARE NONREFUNDABLE. THE BALANCE OF YOUR TOTAL CHARGE WILL BE DUE UPON ARRIVAL AT CAMP. ADULT NAME(S)

Cruz Rodriguez, Alicia LaRosa

ADDRESS CITY

4701 14th St. #9108

STATE

Plano

TX

ZIP

77054

HOME PHONE (469) 467-2204 FAX () EMAIL

BUSINESS PHONE () CELL PHONE (979) 777-0817

alicialarosa07@hotmail.com Our son is on student staff in Houston2

YES NO TOTAL CHARGE = $500 X 50% = DEPOSIT $250

WHAT HAS BEEN YOUR INVOLVEMENT IN YOUNG LIFE?

HAVE YOU BEEN A GUEST AT A YOUNG LIFE CAMP BEFORE? NUMBER OF GUESTS NUMBER OF NIGHTS X PER NIGHT FEE X $50

WHICH CAMP WOULD YOU LIKE TO REGISTER FOR? Frontier

Ranch

CHOICE OF DATES:

1 CHOICE
ST

June 5th-13th

2 CHOICE
ND

AREA OR REGION NAME West AREA OR REGION NUMBER

Houston

TX50

FOR CAMP OFFICE USE: FEE

CHECK NUMBER

YL-6000 (NOVEMBER 2008) PRINTED IN U.S.A.

DATE RECEIVED

DATE NOTIFIED

YL-6000 (NOVEMBER 2008) PRINTED IN U.S.A.