Young Man Boot Camp Registration Form
Mon, July 31 through Thur, Aug. 3, 2023 · 6 to 8:30 pm each night · Northwest Baptist Church, 3500 Trinity Church Dr, Concord, NC 28027
YOUNG MAN INFORMATION:
Young Man:
*
First Name
Last Name
Please select the appropriate pronoun for your son from the extensive list provided:
*
he / him / his
Nickname
Date of Birth
*
Please select a month
January
February
March
April
May
June
July
August
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November
December
Month
Please select a day
1
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Day
Please select a year
2024
2023
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2020
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1920
Year
School
*
Grade Rising into in the Fall 2023
Young Man's T-Shirt Size
*
Please Select
Youth XS
Youth S
Youth M
Youth L
Youth XL
Small
Medium
Large
XL
2XL
3XL
4XL
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
This is for your son -- no worries if he doesn't have an account.
Please list any medical concerns or allergies:
PARENT INFORMATION:
Primary Parent Contact / Name
*
First Name
Last Name
Primary Parent Contact / Cell
*
Primary Parent Contact / Email
*
Secondary Parent Contact / Name
First Name
Last Name
Secondary Parent Contact / Cell
Secondary Parent Contact / Email
Address (only if different from young man being registered)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What do you hope your son will get out of the Young Man Boot Camp?
*
How did you hear about the Young Man Boot Camp?
*
Email from Strategic Families
Strategic Families podcast
Friend
Google Search
Other
Options
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Camp Registration for (1) Young Man, July 31-August 3, 2023
Think of it as a trajectory change from the boy in your life.
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Nike Youth Legend "Shew Thyself a Man" T-Shirt (Black)
Not required but you have to admit: it's a sweet shirt.
$
30.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
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