Summer 2025 YoungLives ChildcareTemplate

WHERE: Rockbridge

170 Spring House Road

Goshen, VA 24439

WHEN: July 05, 2025 - July 09, 2025

Departure: Saturday, July 5th TIME

Return: Wednesday, July 9th TIME

COST: $592, a non-refundable deposit of $100 is required to hold your spot.

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 the Young Life Office at

101 W 14th Street, Suite 206

Greenville, NC 27834

252-757-3717 | [email protected]

Participant Information

Guest Type

Coupon

Registration Options

Register with a deposit or full payment ($592.00)
Please select to make a deposit or full payment below. Your card will not be immediately charged.
Register without a deposit ($592.00)

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.

Phone Type

Participant Address

Gender

Male
Female

Ethnicity

Parent / Guardian Information

Name

Phone

Phone Type

Address is same as participant

Address

Would you like to cover the credit card processing fee?

Total

$0.00

Billing Information

Name

Payment Method

Credit Card
Cash/Check/Offline

Credit Card

Visa
Mastercard
American Express
Discover

Address

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