Summer 2025 Template

WHERE: Rockbridge, 170 Springhouse Road, Goshen VA 24439; (540) 997-9276

WHEN: July 17, 2025 - July 21, 2025

Departure: Early on Thursday, July 17th

Return: Evening on Monday, July 21st

COST: $699, a deposit of $50 is required to hold your spot.

Money is nonrefundable after July 17th.

After completing this form, a confirmation will be sent with the information you have entered below.

Questions and Information

Contact Young Life:

Dorchester County YL, PO Box 1243, Cambridge MD 21613

Area Director: Clint Falduto [email protected] (304) 281-7820

Leaders: Lucas Thorpe (443) 521-7085, Khail Johnson (410) 330-5879

Participant Information

Guest Type

Registration Options

Register with a 50 dollar deposit or full payment ($799.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment/$0 deposit ($799.00)
To register without credit card information, select cash/check/offline. This option will also create a payment link for the full balance listed.

Participant Name

Date of Birth

Participant Phone

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

Phone Type

Participant Email

Opt-in to receive email and text message communications.

You agree to Young Life's terms and privacy policy. Msg & Data rates may apply.

Participant Address

Gender

Male
Female

Additional Comment

Ethnicity

T-shirt Size

School

High School Graduation Year

Additional Comments

Parent / Guardian Information

Parent/Guardian Name

Parent/Guardian Phone

Phone Type

Parent/Guardian Email

Address is same as participant

Address

Would you like to cover the 2.5% credit card processing fee?

Total

$0.00

Participant Information

Parent / Guardian Information

Billing Information