CYC Camp Scholarship Application

Please complete the student (attendee) information below. If the attendee is under 18, the parent/guardian information must also be completed. Once your application is submitted, you may be contacted to discuss your request if we need additional information, otherwise you will receive registration instructions within the next few days.

Attendee Name*
First Last
Attendee's grade this Fall?*
Attendee age*
Attendee Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Attendee Contact Phone*
Attendee Email
Are you a CYC member?*
Who is your small group leader? (Indicate 'None' if you don't know)*
If student is under 18, this section must be completed.
Parent/Guardian Name*
First Last
Parent/Guardian Contact Number*
Please give a brief description of the need for a scholarship:*
The camp fee is $275 through June 12 (early bird) and $325 after. Choose one of the additional scholarship options below.*
There are four options available for scholarships. The least amount that can be paid for camp is $95 per student.
Contact Email*