Lely Young Life Weekend Camp

WHERE: Southwind

WHEN: November 20, 2026 - November 22, 2026

Departure: Friday, November 20

Return: Sunday, November 22

COST: $300, a deposit of $ $50 is required to hold your spot.

Money is nonrefundable after November 6, 2026.

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:

6230 Shirley Street Unit 202 Naples FL 34105

Jose Ramirez | 239-692-2967 | [email protected]

Participant Information

Guest Type

Registration Options

Register with a deposit or full payment ($300.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Leader/Staff ($0.00)

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

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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

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Name

Payment Method

Credit Card
Cash/Check/Offline

Credit CardSecure Payment

Address

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