Summer 2025 Template

Participant Information

Guest Type

Registration Options

Register with a deposit or full payment ($875.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment/$0 deposit ($875.00)
To register without credit card information, select cash/check/offline. This option will also create a payment link for the full balance listed.
Leader ($0.00)
This option is for leaders only
Waitlist ($900.00)
Please choose this option if the camp is full so you will be placed on the waitlist. Your credit card will not be charged until there is a cancellation. No payment is required at this time.

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

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

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

Billing Information

Name

Payment Method

Credit Card
Cash/Check/Offline

Credit Card

Visa
Mastercard
American Express
Discover

Address

Rockbridge Alum Springs

Join us for the best week of your life at WyldLife Summer Camp!

Rockbridge, Goshen, VA

July 17th-21st

Participant Information

Parent / Guardian Information

Billing Information