WyldLife Summer Camp 2020
This form is only to be filled out by parents or guardians over 18 years of age. Thank you for signing your child up for the best week of his/her life!

Where: Rockbridge (www.rockbridge.younglife.org)

When: July 27-31

Trip Cost: $550.00

Three easy steps to sign up:

1. Fill out the form after 6:30pm on Tuesday, Dec. 3rd.

2. Get your $75 deposit (Checks to Young Life) to Jeff (Salem Young Life, PO Box 546, Salem, VA 24153) by Dec. 10th or we will drop your spot to the next person on the list.

3. After submission, check your email for a link to fill out the online health form. YL is offering a $30 Early Signup Incentive for filling out your health form NOW. Please follow the directions in the email and fill out the form to get your discount. This discount is for a LIMITED time and is given on a first come, first serve basis. YL Salem/Glenvar cannot guarantee this discount if your health form is not filled out within 24 hours of the camp signup night.


If you have questions, contact Jeff Lakin 540-343-2026 or Lindsay Ruch 636-667-8665.
Camper's First Name *
Your answer
Camper's Last Name *
Your answer
Parents First Name *
Your answer
Parents Last Name *
Your answer
Parent's email *
Your answer
Parent's Cell Number *
Your answer
Gender *
Grade (as of now) *
Shirt Size *
(adult sizes)
Camp Agreement/Drop Date *
I understand that Salem/Glenvar/Northside YL is under contract with the camp to pay for this camp spot after April 1st. You may drop and get refunds before March 31st without penalty. If your child drops out after March 31st, you are accepting the financial responsibility for that spot regardless of the reason. Exceptions: 1. We find a replacement camper (not currently signed up and willing to pay full price). 2. There is someone from a waiting list (that is willing to pay full price) that will take his/her spot. 3. Salem Young Life is able to give your spot to another YL Area (highly unlikely).
Camp Agreement/Fundraiser Refunds *
I agree that all money raised through Young Life fundraisers is non-refundable. If your child drops out of camp, all fundraiser money will be put into a general camp scholarship fund.
Camp Agreement *
I agree that Salem Young Life will offer at least one fundraiser for my child to participate in. I understand that participation in these fundraisers is optional and is up to the parents and the camper to participate. YL staff and leaders will help but the responsibility rests on each camper to make the most of the fundraiser(s) offered. Salem Young Life does not guarantee an amount that can be raised through fundraisers. Each parent and child is responsible to pay for camp regardless of fundraisers.
Camp Agreement/Esignature *
Please give your name and phone number in the space below as your signature agreeing to all of the above.
Your answer
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