Summer 2025 Template

WHERE: Clearwater Cove 2565 State Hwy H, Lampe, MO 65681

WHEN: July 18, 2025 - July 23, 2025

Departure: early morning on July 18

Return: late evening July 23

COST: $999, a deposit of $200 is required to hold your spot.

Money is nonrefundable after April 1, 2025

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

Questions and Information

Contact Jia Martin at:

(260) 579-1813

[email protected]

Participant Information

Guest Type

Registration Options

Participant Name

Date of Birth

Participant Email

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Participant Address

Gender

Male
Female

Additional Comment

Ethnicity

T-shirt Size

School

High School Graduation Year

Parent / Guardian Information

Parent/Guardian Name

Parent/Guardian Phone

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Phone Type

Parent/Guardian Email

Address is same as participant

Address

Total

$0.00

Financial Commitment*

By checking this box, I confirm that my deposit is nonrefundable after January 10 and any additional payments are nonrefundable after March 30.

Billing Information

Name

Payment Method

Credit Card
Cash/Check

Credit Card

Visa
Mastercard
American Express
Discover

Address

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