JMU Young Life College Fall Weekend 2026

Student Information

Guest Type

Registration Options

Register with a deposit or full payment ($175.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment/$0 Deposit ($175.00)
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

Phone Type

Participant Address

Gender

Male
Female

Special Diets

Ethnicity

Projected Graduation Year

Parent / Guardian Information

Parent/Guardian Name

Parent/Guardian Phone

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Phone Type

Parent/Guardian Email

Address is same as participant

Address

Coupon Code

Would you like to cover the 2.5% processing fee?

Total

$0.00

By filling out this form, you are opting in to Young Life communications.
In the future, you will be given the opportunity to manage your communication preferences.

Billing Information

Name

Payment Method

Credit Card
Cash/Check/Offline

Credit Card

Visa
Mastercard
American Express
Discover

Address

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