Young Life Camp

WHERE: Washington Family Ranch

WHEN: November 06, 2026 - November 08, 2026

Departure: FRIDAY, 11/06 @4PM

Return: SUNDAY, 11/08 @6PM

COST: $215, a deposit of $20 is required to hold your spot.

Money is nonrefundable after 10/22

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:

417 E 13TH Ave Eugene, OR 97401

541-903-2909 - [email protected]

Participant Information

Guest Type

Registration Options

Register with full payment ($215.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with deposit ($20.00)
Please select to make a deposit or full payment below. This will be paid by credit card.

Participant Name

Date of Birth

Phone

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

Name

Payment Method

Credit Card
Cash/Check/Offline

Credit Card

Visa
Mastercard
American Express
Discover

Address

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