Young Life Camp

WHERE: 247 Mohican Lake Rd, Glen Spey, NY 12737

WHEN: December 4, 2026 - December 6, 2026

Departure: Friday around 6:00pm at Dallas High School parking lot

Return: Sunday around 2:00pm at same location

COST & EARLY REGISTRATION

Regular Price: $195

Register before November 15: $170 – $25 OFF!

A $50 deposit is required to hold your spot!

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

Questions and Information

Noah MacQuarrie - Area Director

(724) 730-9799 - [email protected]

Participant Information

Guest Type

Registration Options

Register with a deposit or full payment ($170.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment/$0 Deposit ($170.00)
To register without credit card information, select cash/check/offline. This option will also create a payment link for the full balance listed.

Participant Name

Date of Birth

Phone

Phone Type

Participant Address

Gender

Male
Female

Ethnicity

School

High School Graduation Year

Additional Comments

Parent / Guardian Information

Parent/Guardian Name

Parent/Guardian Phone

Yes, it's okay to send me text messages including order confirmations, updates, event reminders, and event information. Message frequency varies. Message and data rates may apply. Reply HELP for help, STOP to cancel. View our terms of service & privacy policy.

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

Secure checkout PCI compliant

Name

Payment Method

Credit Card
Cash/Check/Offline

Credit CardSecure Payment

Address

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