Summer 2025 YoungLives Template

WHERE: Rockbridge

WHEN: July 6, 2025 - July 9, 2025

Departure: July 6, 11:30 a.m

Return: July 9, 3:00 p.m.

COST: $TBD, a deposit of $ 50 is required to hold your spot.

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:

PO Box 300, Blacksburg 24063

(540) 418-6287 - [email protected]

Participant Information

Guest Type

Are you bringing a child?

Registration Options

Register with a deposit or full payment ($650.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment/0 deposit ($650.00)
Please select to register without a deposit or to make an offline payment by sending cash/check to the YL office directly.

Participant Name

Date of Birth

Phone

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

Phone Type

Participant Address

Gender

Male
Female

Ethnicity

Other Languages Spoken

T-shirt Size

High School Graduation Year

Parent / Guardian Information

Fill out the following parent/guardian information for the participant you are registering above.

Parent/Guardian Name

Parent/Guardian Phone

Yes, it's okay to send me text messages including confirmations, changes, and updates. 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

Parent/Guardian Address

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.

Participant Information

Parent / Guardian Information

Billing Information