Summer 2025 Template

WHEN: July 15, 2024- July 20, 2024

Departure: July 15, around 5:00AM (final time still to be determined)

Return: July 20, around midnight (final time still to be determined)

COST: $975.

A deposit of $75 is required to register.

Deposit is nonrefundable after Janurary 15, 2025.

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

We don't want money to hold anybody back from attending Camp. We plan to hold several fundraising events leading up to Camp to do all we can to assist with the cost.

Campership opportunities:

1) Christmas Wreath Fundraiser - now starting! For every wreath you sell, $10 will be applied towards your camp trip.

2) Wing-a-thon - will be scheduled for the spring

More opportunities in the works and will be communicated asap!

Questions and Information

Contact at the Young Life Office at:

Dulles South Young Life 25050 Riding Plaza, Suite 130 #214, South Riding, VA 20152

[email protected]

Participant Information

Guest Type

Registration Options

Participant Name

Date of Birth

Participant Phone

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

Sweatshirt/Hoodie size

School

High School Graduation Year

Additional Comments

Parent / Guardian Information

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

Address

Credit Card Fee

$0.00

The credit card fee will cover the entire cost of the camp trip, not just the deposit. However, this will be the only be credit card fee collected.

Total

$0.00

Billing Information

Name

Payment Method

Credit Card
Cash/Check/Offline

Credit Card

Visa
Mastercard
American Express
Discover

Address

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