Summer 2025 YoungLives Template

WHERE: Rockbridge

170 Spring House Road

Goshen, VA 24439

WHEN: July 06, 2025 - July 09, 2025

Departure: Sunday, July 6th

Return: Wednesday, July 9th

COST: $50 for first time camper and $100 for returning camper

Money is nonrefundable after June 21st

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:

101 W. 14th Street, Suite 206

Greenville, NC 27834

252-757-3717 | [email protected]

Participant Information

Guest Type

Are you bringing a child?

Registration Options

This is my first time at YoungLives camp ($50.00)
1st time campers only
This is not my first time at YoungLives camp ($100.00)
Use this to pay $100 because you are not a first-time camper

Participant Name

Date of Birth

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.

Participant Address

Gender

Male
Female

Ethnicity

Other Languages Spoken

T-shirt Size

High School Graduation Year

Additional Comments

Parent / Guardian Information

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

Parent/Guardian Name

Parent/Guardian Phone

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