UCYC 2023 Application
June 18-24
All applications are due Sunday, April 30. A camper application fee is $75 and a staff application fee is $30. UCYC accepts cash, check or Venmo to @ucyc2021. If you have further questions please email uppercumberlandyouthcamp@gmail.com or contact your youth leader.

A mandatory staff orientation will be held in person at Cookeville FWB Church or via Zoom for those unable to attend in person. Staff - Be sure to include your email address below for more info regarding orientation. 

Please be aware that the UCYC Board reserves the right to deny any camper or staff application. Past performance as a camper or volunteer may aid in the board's decision to deny applications. 
Sign in to Google to save your progress. Learn more
Applicant Name *
I am applying to be a:  *
Required
Applicant Age *
Applicant DOB *
MM
/
DD
/
YYYY
Parent/Guardian Name
Parent/Guardian Emergency Phone # *
E-Mail Address (required for staff members)
Church Affiliation 
Does Camper have medical issues/allergies? If so, please explain.  *
Can Camper swim? 
Please send $1 for swim night. 
 *
Camper may choose one roommate:
T Shirt Size (applicable for campers and staff applicants) *
Required
Do you plan to stay the entire week at UCYC? Only those staying all week will get first priority if capacity is reached. *
Applicant Signature 
By signing my name electronically, I agree to abide by all UCYC rules. 
 *
Parent/Guardian Signature
By signing my name electronically, I give permission for my child to attend UCYC and give permission for any medical attention necessary due to sickness or accident. 
 *
I understand that in order to secure my spot at UCYC my application fee needs to accompany my online application. $75 campers, $30 workers. 
Feel free to make an additional donation to UCYC missions on top of your application fee to support our students.
Venmo @ucyc21 or make checks payable to UCYC. 
 *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms