Capernaum Charlottesville Fall Weekend

WHERE: Rockbridge Alum Springs

WHEN: October 16, 2026 - October 18, 2026

Departure: Friday, October 16th at 6pm

Return: Sunday, October 18th around 2pm

COST: $234

A deposit of $50 is required to hold your spot.

The deposit is nonrefundable after September 18th.

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

Questions and Information

Contact the Young Life Office at:

[email protected]

Participant Information

Guest Type

Registration Options

Register with a deposit or full payment ($234.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment/$0 Deposit ($234.00)
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

Phone

Phone Type

Participant Address

Gender

Male
Female

Ethnicity

T-shirt Size

School

Dietary Restrictions

Additional Comments

Parent / Guardian Information

Parent/Guardian Name

Parent/Guardian Phone

Yes, it's okay to send me text messages including order confirmations, updates, event reminders, and event information. Message frequency varies. Message and data rates may apply. Reply HELP for help, STOP to cancel. View our terms of service & privacy policy.

Phone Type

Parent/Guardian Email

Address is same as participant

Address

A 2.5% fee will be added to credit card transactions.

Total

$0.00

By filling out this form, you are opting in to Young Life communications.
In the future, you will be given the opportunity to manage your communication preferences.

Billing Information

Secure checkout PCI compliant

Name

Payment Method

Credit Card
Cash/Check/Offline

Credit CardSecure Payment

Address

Safe & Secure Checkout PCI-compliant • 256-bit AES encryption

Event Registration Software by RegFox