Summer 2025 Template

WHERE: Lost Canyon - Williams, AZ

WHEN: July 5 - July 9

Departure: TBD

Return: TBD

COST: $800, a deposit of $50 is required to hold your spot. PRICE INCREASES MARCH 1st

The reason for increased prices from last year is an increase in camp cost and the cost of chartering a bus to Arizona which costs approximately $10,000.

Money is nonrefundable after June 24th

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

Questions and Information

Contact Logan Jacobs at [email protected] or 919-805-8280

Participant Information

Guest Type

Summer 2025

Middle School Camp - July 5-9

Registration Options

Register with a deposit or full payment ($800.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register as Leader ($0.00)

Participant Name

Date of Birth

Participant Phone

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Participant Address

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Additional Comment

Ethnicity

T-shirt Size

Additional Comments

Parent / Guardian Information

Parent/Guardian Name

Parent/Guardian Phone

Phone Type

Parent/Guardian Email

Address is same as participant

Address

Total

$0.00

Participant Information

Parent / Guardian Information

Billing Information