Summer 2025 Template

WHO: All Capernaum Friends in the Richmond West End

WHERE: Rockbridge Alum Springs Young Life Camp

WHEN: August 7th-August 11th

COST: $800 for Campers

This will cover all of your expenses for the week including transportation, food, lodging, and all the fun you can pack into 5 days! We will depart from Richmond Thursday, August 7th at 10:00am and return Monday, August 11th around 2:30pm. A $250 deposit is required to register and save your spot.

Deposits will be NON-REFUNDABLE after March 31, 2025

Please contact Richmond West End Capernaum Coordinator Blair Brown with any questions!

Phone: (804) 543-8227 or Email: [email protected]

Participant Information

Guest Type

Registration Options

Register with a deposit or full payment ($800.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment/$0 deposit ($800.00)
To register without credit card information, select cash/check/offline.
Register as a Buddy ($400.00)
Register as a Leader ($0.00)

Participant Name

Date of Birth

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Participant Address

Gender

Male
Female

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Ethnicity

T-shirt Size

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Parent / Guardian Information

Parent/Guardian Name

Parent/Guardian Phone

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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