Summer 2025 Template

WHERE: Southwind (18115 SE 95th Street Road, Ocklawaha, FL 32179)

WHEN: June 24, 2025 - June 28, 2025

Departure: We will depart from the Rouses on St. Charles Street in Houma Tuesday, June 24th, at 3 a.m. CST.

Return: We will depart Southwind Saturday, June 28th, at 11 a.m. EST.

COST: $899, a deposit of $200 is required to hold your spot. We will be offering an early bird discount of $15, if you sign up before Christmas break.

Deposits are non-refundable after January 15th, and all other payments are non-refundable after March 31st.

After completing this form, a confirmation will be sent with the information you have entered below.

Questions and Information

Contact at our Area Director, Cody Sanders, at:

Cell Phone: 337-280-4920

Email: [email protected]

Participant Information

Guest Type

Registration Options

Register with a deposit ($200) or full payment ($899.00)
Please select this option if you intend to pay with a credit card.
Register as a leader ($0.00)
PLEASE ONLY USE IF YOU ARE A LEADER ON THIS TRIP.
Deposit paid in cash or check ($899.00)
Registered with a $200 cash or check deposit.

Participant Name

Date of Birth

Participant Phone

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Phone Type

Participant Email

Opt-in to receive email and text message communications.

You agree to Young Life's terms and privacy policy. Msg & Data rates may apply.

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% credit card processing fee?

Total

$0.00

Participant Information

Parent / Guardian Information

Billing Information