Summer 2025 Template

WHERE: Rockbridge Alum Springs in beautiful Goshen, VA

WHEN: July 27, 2025 - July 31, 2025

Departure: early morning on Sunday, July 27th - exact time TBD

Return: late evening on Thursday, July 31st - exact time TBD

COST: $725, a deposit of $150 is required to hold your spot.

Money is nonrefundable after February 1, 2025.

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:

Mike Ambuske, Area Director

P.O. Box 4, Butler, PA 16003

(937) 207-8951 or [email protected]

Participant Information

Guest Type

Registration Options

Register with full payment ($725.00) [10 remaining]
Please select to make the full payment below. This will be paid by credit card.
Register with a $150 deposit ($725.00) [10 remaining]
Please select to make a $150 deposit payment below. This will be paid by credit card.

Participant Name

Date of Birth

Participant 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. Reply STOP to cancel.View our terms of service & privacy policy.

Phone Type

Participant Email

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

Participant Address

Gender

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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