Summer 2025 YoungLives ChildcareTemplate

WHERE: Rockbridge Alum Springs - 170 Spring House Rd. Goshen, VA 24439

WHEN: July 5-July 9, 2025

COST: $592 and a deposit of $ 50 is required to hold your spot.

Money is nonrefundable after 6/15/25

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:

Esther Horner

[email protected]

804-539-6165

PO Box 5682

Springfield, VA 22150

Participant Information

Guest Type

Registration Options

Register with a deposit or full payment ($592.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment/0 deposit ($592.00)
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

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

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

Ethnicity

Emergency Contact/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

Participant Information

Emergency Contact/Parent / Guardian Information

Billing Information