CYIA Student Registration - 2024
If you've come to this form prematurely and just need more information, click here: CYIA Summer Missions  

If you're ready to sign up for CYIA, please complete this registration form to apply.  Once you have submitted this document, an interview will be scheduled with each new student and a parent.  Watch your email for letters of acceptance with instructions for next steps.  Questions?  Call the CEF office at 931-241-8202.
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Student Name  *
Age *
Date of Birth *
MM
/
DD
/
YYYY
Street Address *
City and Zip code *
Student's Phone Number (put "none" if no personal phone) *
Student Email (put "none" if no email) *
Please share briefly your salvation testimony (new student only)
Please share about your relationship with Jesus since your salvation  (new student only)
What church are you a member of (new student only)?
Church location  (new student only)
How did you hear about CYIA  (new student only)?
Why do you want to be involved in CYIA  (new student only)?
Are you available for the pretraining weekend? Friday, April 12th at 4:00 pm through Sunday, April 14th at 4:00 pm at Cumberland Youth Camp in Woodlawn *
Are you available for all of camp? Sunday, May 26th at 3:00 pm through Friday, May 31st at 5:00 pm at Linden Valley Conference Center *
Which weeks are you unavailable to do 5-Day Clubs? Check only the boxes you are UNavailable.
I am unavailable
June 3rd-7th
June 10th-14th
June 17th-21st
June 24th-28th
July 8th-12th
July 15th-19th
July 22nd-26th
Please rank the weeks in order of preference  that you'd like to serve.  You can use the same choice for more than one week. Leave blank if you are unavailable for a particular week.
First Choice
Second Choice
Third Choice
Fourth Choice
Fifth Choice
Sixth Choice
Seventh Choice
June 3rd-7th
June 10th-14th
June 17th-21st
June 24th-28th
July 8th-12th
July 15th-19th
July 22nd-26th
Clear selection
Do you drive? *
Do you have a car? *
Do you have transportation to the pretraining weekend? *
Do you have transportation to training camp? *
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