Rotary Clubs please complete this form to reserve spaces at the next RYLA.
This is NOT the student registration form :)

Club RYLA Chair Contact Information & Club Reservation

The club's RYLA coordinator must be a member of the club who will act as the liaison between the RYLA Administration, the school and the student.

Club: Coordinator First Name: Coordinator Last Name: Email: Phone Number: Notes:

Reservation Information

Full payment due by September 30. Late payments subject to potential waiting list status until spaces open for confirmation.

Registration is not complete until RYLA Staff acknowledges payment in full. Failure to pay on time may result in the forfeiture of your Space Reservations. RYLA Staff is here to help if you have special circumstances and need an extension. Please contact with any questions or special requests.


Reserve Spaces (at $400 each): (Select 0 if you are only contributing to the scholarship fund)   All clubs must include a contribution towards the RYLA scholarship fund:
0 spaces (contribution only), $50 minimum.
1 to 4 spaces, $15 minimum per space.
5+ spaces, $100 minimum total contribution.


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