Summer 2025 Template

WHERE: Rockbridge

WHEN: June 22, 2025 - June 27, 2025

Departure: Sunday June 22nd

Return: Friday June 27

COST: $899, a deposit of $150 is required to hold your spot.

Deposit is nonrefundable after March 28, 2025.

After completing this form, a confirmation will be sent with the information you have 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 ($899.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment/$0 deposit ($899.00)
To register without credit card information, select cash/check below. This option will also create a payment link for the full balance listed.

Summer Camp

Rockbridge

Participant Name

Date of Birth

PLEASE DOUBLE CHECK BIRTHDATE. Make sure it does not autofill the incorrect birthday for your registrant. Thanks!

Participant Phone

Phone Type

Participant Email

Opt-in to receive email and text message communications.

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

Grade

Additional Comments/Dietary Restrictions

Parent / Guardian Information

Parent/Guardian Name

Parent/Guardian Phone

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Phone Type

Parent/Guardian Email

Address is same as participant

Address

If paying with credit card, I agree to cover the 2.5% processing fee.

Total

$0.00

Participant Information

Parent / Guardian Information

Billing Information