Apply for RYLA 2019

Dates: April 26th-28th

Location: Camp Redwood Glen, Scotts Valley

Transportation will be provided

Student Information
Student Name *
Student Name
Phone *
Phone
Please use a mobile number if you have one
Address *
Address
Your Birthdate *
Your Birthdate
We support students with a unique gender, gender identity, or gender expression; if you select "other" we will reach out.
Must be in 10-12 grade
RYLA Short Answer Questions
I pledge to attend and participate in all three days of RYLA. I will also return all forms on-time. *
Parent/Guardian Information
Parent/Guardian Name *
Parent/Guardian Name
Parent/Guardian Phone *
Parent/Guardian Phone
Rotarian Contact (if applicable)
Rotarian Contact (if applicable)