YoungLives VB South Rockbridge 2024

WHERE: Rockbridge Alum Springs

WHEN: July 13, 2024 - July 17, 2024

COST: $750, a deposit of $50 is required to hold your spot.

Money is nonrefundable after May 1

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

Questions and Information

Contact at the Margaret Pittman at:

[email protected]
(757) 641-0464

Guest Type

Are you bringing a child?

Registration Options

Register with a deposit or full payment ($750.00)
Please select to make a deposit or full payment below. Your card will not be immediately charged.
Register without a deposit ($750.00)
Leader ($0.00)

Participant Name

Date of Birth

Phone

Phone Type

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

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

Phone Type

Parent/Guardian Email

Address is same as participant

Parent/Guardian Address

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

Total

$0.00

Important: Before you press submit...

Deposits are nonrefundable after May 1st.

You may pay your deposit by check (preferred) or by credit card.

Check or Cash Payment: If you do not want to pay online (and avoid credit card fee of 4%) you can write a check for $50 (or more up to $750) to "Young Life," put your student's name & school on the memo line, and mail to: Young Life, P.O. Box 4492, Virginia Beach VA 23454 or cash/check can be given to your Young Life leader to reserve your spot. Then complete this page by filling out the Billing Information section, choosing the Cash/Check option, and then pressing submit.

Credit Card: To pay by Credit Card fill out the Billing Information section, click the Credit Card option below, and then press submit. IMPORTANT: If using a Credit Card, an additional 4% will be automatically added to cover fees from CC companies. ($80 for deposit, $780 for full payment).