Campaigner Overnight

WHERE: Rockbridge Alum Springs

WHEN: August 23, 2025 - August 24, 2025

Departure: August 23, 2025 9:00 a.m.

Return: August 24, 2025 2:00 p.m.

COST: $ 75

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]

Participant Information

Guest Type

Registration Options

Register with an online payment ($75.00)
Please select to make an online payment below. This will be paid by credit card.
Register with an offline payment/$0 Deposit ($75.00)
To pay using cash or check, select cash/check/offline. This option will also create a payment link for the full balance listed. You can bring your cash/check payment to registration the day of.

Participant Name

Date of Birth

Phone

Phone Type

Participant Address

Gender

Male
Female

Ethnicity

School

High School Graduation Year

Parent / Guardian Information

Parent/Guardian Name

Parent/Guardian Phone

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Phone Type

Parent/Guardian Email

Address is same as participant*

Address

Would you like to cover the 2.5% processing fee?

Credit Card Process Fee

$0.00

Total

$0.00

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In the future, you will be given the opportunity to manage your communication preferences.

Billing Information

Name

Payment Method

Cash/Check/Offline

Please enter billing information, which may be different from above.

Address

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