2024 UCYC Application 
Camp Date : June 16-22, 2024
Application Deadline : April 30, 2024

IMPORTANT: All applications will be either approved or denied by a Liberty Association pastor, youth leader or UCYC board member. You will receive an email no later than May 10, 2024 confirming your acceptance as a camper or staff member for UCYC 2024. Please be aware that UCYC 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. 

A mandatory staff orientation will be held in person at Cookeville FWB Church on Saturday, June 1, 2024 at 10:00 am. A Zoom link will be provided for those who are unable to attend in person.

If you have further questions, please email uppercumberlandyouthcamp@gmail.com or contact your youth leader.

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Applicant Name *
I am applying to be a:  *
Applicant Age  *
Applicant DOB
MM
/
DD
/
YYYY
Parent/Guardian Name

If you are applying to be a staff member please initial below. 
 *
Parent/Guardian Emergency Contact # *
E-mail address 
*This is where your UCYC acceptance notification will be sent.
 *
Church Affiliation *
Pastor or Youth Leader Name *
Does Camper have medical issues/allergies? If so, please explain. 
Can Camper swim?
Please send $1 for swim night. 
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Camper may choose one roommate:
T Shirt Size (applicable for campers and staff applicants) *
Do you plan to stay the entire week at UCYC? Only those staying all week will get first priority if capacity is reached.  *
I give my consent for UCYC to share photos of myself (staff) or my child (camper) in the camp video and on UCYC's social media platforms.  *
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 am acknowledging that I am the legal custodian of the minor applicant. 

If you are a staff applicant, please initial below. 
 *
I understand that in order to secure my spot at UCYC my application fee must accompany my online application.
$75 camper, $30 staff fee
Venmo @ucyc21 or make checks payable to UCYC. 
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