Summer 2025 Template

WHERE: Lost Canyon (1450 S Perkinsville Rd, Williams, AZ 86046)

WHEN: July 23, 2025 - July 28, 2025

Departure: Wednesday, July 23rd (Early morning/Details TBD)

Return: Monday, July 28th (Late evening/ Details TBD)

COST: $700, a deposit of $ 100 is required to hold your spot.

Money is nonrefundable after July 1st.

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

Questions and Information

Contact Mackenzie Rottler at

818.915.3205 or [email protected]

Participant Information

Guest Type

Registration Options

Register with a deposit or full payment ($700.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment/$0 deposit ($700.00)
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

Participant Phone

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Phone Type

Participant Email

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Participant Address

Gender

Male
Female

Additional Comment

Ethnicity

T-shirt Size

School

High School Graduation Year

Dietary Restrictions

If yes, then select

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