2024 Lost Canyon Wk 6

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

WHEN: 07/05/2024 - 07/09/2024
Departure: Friday, July 5th at 8 AM
Return: Tuesday, July 9th around 10 PM

COST: $562, a deposit of $25 is required to hold your spot.
Financial assistance such as discounts, scholarships, and fundraising opportunities will be available.
Money is nonrefundable after June 1st, 2024.

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

Questions and Information

Contact your WyldLife Trip Leader Claudia Silva at:
[email protected] or 505-382-4038

Participant Information

Guest Type

Participant Name

Date of Birth

Phone

Phone Type

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Participant Address

Gender

Male
Female

Additional Comment

Ethnicity

T-shirt Size

School

High School Graduation Year

Parent / Guardian Information

Name

Phone

Phone Type

Address is same as participant

Address

Would you like to cover the 2.5% credit card processing fee?

Total

$0.00

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