Summer 2025 Template

WHERE: Rockbridge Alum Springs, in Goshen, VA

WHEN: June 15, 2025 - June 20, 2025

Departure: June 15th around 11:30 AM.

Return: June 20th around 2:30 PM.

COST: $799, a deposit of $100 is required to hold your spot.

Money is nonrefundable after April 15th.

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

Questions and Information

Contact at the Young Life Office at:

[email protected]

434-260-3271

Participant Information

Guest Type

Registration Options

Register with a deposit or full payment ($799.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment/$0 deposit ($799.00)
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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You agree to Young Life's terms and privacy policy. Msg & Data rates may apply.

Participant Address

Gender

Male
Female

Additional Comment

Ethnicity

T-Shirt Size

School

High School Graduation Year

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?

Would you like to donate along with your payment to help cover bus costs, leaders, or provide scholarships for other students?

Total

$0.00

Central Virginia - Young Life Summer Camp 2025

Participant Information

Parent / Guardian Information

Billing Information