Camp JYC Facility Use Request
This is the first step to rent Camp JYC!
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Group/Organization *
Contact Person *
Phone *
Street Address *
City *
State *
Zip *
E-Mail *
Person in charge at time of use *
Rental Rates:
Length of stay *
Requested Check-in Day *
MM
/
DD
/
YYYY
Requested Check-out Day *
MM
/
DD
/
YYYY
A Camp JYC team member will meet with you for check-in/out.
If you are requesting non-standard check-in time (must be coordinated first), please enter it here:
Time
:
If you are requesting non-standard check-out time (must be coordinated first), please enter it here:
Time
:
Deposit of half the total cost is required to secure dates. Remaining balance is due at check-in.
Method of payment *
Total cost *
Amount of deposit *
Camp JYC and First Baptist Church are not responsible for providing staff or lifeguards.
When you check in, you will be required to have:
✓ A signed copy of the Camp JYC Rules and Regulations.
✓ A completed and signed copy of the Facility Usage and Hold Harmless Agreement.
✓ If using Camp JYC for children’s (ages 1-18) events without parents present, provide a Certificate of Liability Insurance with Camp JYC included as “Additional Insured” for the dates of your stay and a statement in the "Special Provisions” box indicating a sexual misconduct background check has been completed for all staff.
✓ If using Camp JYC for a children’s camp as defined by the NYS Department of Health (children 16 years old and under for more than 72 hours), you MUST contact the Cattaraugus County Health Department at http://www.cattco.org/health and comply with all applicable regulations.

Please submit your payment by mailing a check or money order to Camp JYC, c/o First Baptist Church, 27 South Main Street, Franklinville, NY 14737. You will be contacted when we have received your deposit to confirm your requested dates.

Thank you for your interest in Camp JYC.
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