YL Fall Weekend Nov 6

WHERE: Rockbridge Alum Springs

WHEN: November 06, 2026 - November 08, 2026

Departure: Friday, November 6th @ 8PM

Return: Sunday, November 8th @ 2PM

COST: $250, 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:

[email protected] or contact your Young Life Leader!

Participant Information

Guest Type

Registration Options

Register with a $50 deposit
Please select to make a deposit online via credit card. You will receive a payment link to pay the remaining balance by the departure date
Register with a full payment
Please selected if you wish to pay the full amount today using a credit card
Register with an offline payment
Please select to pay via cash or check. You can send payment to the Young Life office or give to your Young Life leader

Participant Name

Date of Birth

Phone

Phone Type

Participant Address

Gender

Male
Female

Additional Comment

Ethnicity

School

High School Graduation Year

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

Would you like to cover the 2.5% processing fee?

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