Registration

Mentoring Your Son to Be Happier and More Independent

Young men are welcome to register any time before the weekend or on the Friday that the weekend begins. Whether registered before the weekend or at the weekend, all young men must arrive between 4:00 PM – 6:30 PM on the Friday their weekend begins. Special arrangements for late arrivals will be considered on a case-by-case basis with the parent or guardian before the weekend.

 

Tuition is $295.00 with an “Early Registration” of $265.00 if paid in full 14 Days prior to Weekend. No personal checks are accepted within 7 days of the event and tuition must be paid in full prior to participation. We have a no refund policy within 7 days of the weekend start date but your payment can be credited toward any future YMUW events. An additional $25 will be charged for returned checks. If paying by credit/debit card, please use the payment option upon completion of the registration process below.

To Register for Any Weekend

1. If paying online by credit or debit card (the best way!) complete the form below.

2. If paying by check or money order, you can download the *Weekend Registration Form and fax or mail it to the office listed on the form (PDF file may be completed electronically then printed out). Please note that signatures are required. If you mail the registration form, please remember to enclose your check or money order. If you fax the registration form, you can mail the payment separately. Make checks or money orders payable to “YMUW”.

CONFIRMATION LETTER (PDF Format) Click on link to download

*Note: Form is in PDF format which requires that Adobe’s “Acrobat Reader” be installed on your computer. A free copy is available at www.adobe.com.





Registration

Purpose of the Young Men’s Ultimate Weekend:
To provide young men a weekend filled with incredible fun and challenges,
while building a foundation for a confident and successful adulthood,
through learning the importance of teamwork, developing a
sense of accomplishment and acquiring leadership skills.

2017 Weekends – *Please Select One
   YMUW_July_2017  July 7th–9th, Boulder Creek, CA NEW DATE
 YMUW_September_2017  September 15th–17th, The Cove Scout Camp, Napa, CA
 
How did you hear about YMUW? If Other:
 

PARTICIPANT PERSONAL INFORMATION

*Last Name:  
*First Name:  
*Address:  
*City: *State: *Zip:
*Home Phone: Work: *Cell:
*E-mail: 
Grade Level: *Date of Birth: *Age:
List any physical, psychiatric or medical conditions
we should know about:
 

PARENT/GUARDIAN INFORMATION

 I Agree *I have read, and agree the attached Terms and
Conditions: Terms & Conditions PLEASE READ CAREFULLY
*Parent/Guardian Name:
Address:
(if different from participant)
*Relationship to participant:
*Home Phone: *Work: *Cell:
*E-Mail:
*Emergency Contact:
*Emergency Phone:
 

SPONSOR INFORMATION (optional)

Sponsor Name:
Home Phone: Work: Cell:
 
Address:  
E-Mail:  
Organization:  
 

PARTICIPANT MEDICAL INFORMATION

*Doctor’s Name: *Doctor’s Phone:
 
Insurance Carrier Name:
   
Insurance/Group Plan #: ID#:
 
 
List any medication you will be taking during the weekend:
Special dietary requirements:
Allergies:

 

Check all items that apply, past or present, to your health history. Please explain any checked items.

  Asthma  yes  
  Diabetes  yes  
  Kidney Disease  yes  
  Cancer/Leukemia  yes  
  Heart Trouble  yes  
  Convulsions  yes  
  Hemophilia  yes  
  Seizures  yes  
  High Blood Pressure  yes  
Please Explain:
List any physical or behavioral conditions that may affect or limit full participation in swimming, backpacking, hiking or strenuous physical activities:
 
Do you have a history of walking in your sleep?  yes
 

List special equipment needed such as wheelchair, braces, glasses, contact lenses, etc.

 

MY COMMITMENTS AS A PARTICIPANT

  1. I understand the Young Men’s Ultimate Weekend may take place in a wilderness setting and will be physically demanding. I will give my best to this challenge.
  2. I will not bring any electronic equipment, non-prescription drugs, illegal materials, weapons, tobacco or alcohol. I will not smoke tobacco/anything during this event.
  3. I will ensure the safety for myself and other young men at all times.
  4. I am enthusiastic about this weekend and I agree to participate fully with a positive attitude!
  5. I understand I am making a commitment to be prepared for and attend the Young Men’s Ultimate Weekend.
  6. I understand that I may be removed from the Weekend if I fail to comply with any of these commitments.

 I Commit   *I have read, and agree to these commitments.

When you have completed the Registration application, please click on the "Send Registration and Make Payment" button below to complete your payment.  Thank You.

Note: If you are not taken to the payment page, please review your form above to ensure all required fields are completed.