Dublin Jerome Fall Weekend!

Join hundreds of your friends for the BEST weekend of the year!

Northwest Columbus Young Life

Dublin Jerome High School | November 20 - 22

WHERE: Heartland Conference Retreat Center | 3201 CR 225 Marengo, OH 43334 | 740-747-0220

WHEN: November 20 - 22, 2026

Departure: Friday, November 20th around 9p

Arrival Home: Sunday, November 22nd around 1p

*Details regarding departure/return information will be communicated closer to Fall Weekend. These details, along with other pertinent weekend information, will be emailed to the email address you enter on the registration form below.

Questions?

Contact Brittany Troast (Administrative Assistant) by sending an email to [email protected]

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

Additionally, Form 1717 - Short Health and Activity Consent Form - must be completed online prior to departure in order to participate in any activities. Please ensure all email addresses and the participant's birthday are correct when completing the fields below. An email to complete this form will be sent closer to Fall Weekend. A separate communication will be emailed regarding a suggested packing list, policies surrounding electronics, medications, leader contacts and a form to complete if your child will be leaving early from camp.

Participant Information

Fall Weekend 2026

Count Me In!

Guest Type

Registration Options

Register with a deposit or full payment using a CREDIT/DEBIT card ($160.00)
Please select to make a $50/deposit or full payment below is you're paying TODAY with a credit/debit card. If paying a deposit, all balances must be paid in full prior to bus departure on November 20th.
Register with an OFFLINE payment ($160.00)
Please select to make a $0 deposit/payment below if you plan to make an OFFLINE (check/cash) payment at a later date. All balances must be paid in full before bus departure on November 20th.

Participant Name

Date of Birth

Phone

Phone Type

Participant Address

Gender

Male
Female

Ethnicity

School

High School Graduation Year

Anything else you'd like us to know? (Dietary Restrictions, Allergies, Special Accommodations, Medical History, Arriving Late/Leaving Early, etc.)

Parent / Guardian Information

Parent/Guardian Name

Parent/Guardian Phone

Yes, it's okay to send me text messages including order confirmations, updates, event reminders, and event information. Message frequency varies. Message and data rates may apply. Reply HELP for help, STOP to cancel. View our terms of service & privacy policy.

Phone Type

Please ensure the email address entered below is your personal email address as the health form and all pertinent Fall Weekend information will be sent via email. We ask that you check for typos before submitting!

Parent/Guardian Email

Address is same as participant

Address

Would you like to cover the 4% 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.

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Billing Information

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Name

Payment Method

Credit Card
Cash or Check

Credit CardSecure Payment

Address

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FALL WEEKEND!

Participant Information

Parent / Guardian Information

Billing Information