2026 CIY Student Pre-Registration (#1)

Student Name*

First NameLast Name

Date of Birth *

Date

Student's Gender*

MaleFemale

Shirt Size*

Does the Student have their own phone number?*

YesNo

Please enter Student's phone number:

Does the Student have their own email address?*

YesNo

Please enter Student's email address:

Parent/Guardian Name*

First NameLast Name

Parent/Guardian Phone Number:*

Please enter a valid phone number.

Parent/Guardian Email Address: *

example@example.com

Do you give Castleton Christian Church Staff and/or Volunteers permission to provide your student with medication, if needed, such as: Tylenol, Ibuprofen, Benadryl, etc?*

YesNo, please call me first.

Important Information:

Please know, if your student has not met the requirements for eligibility for this trip, or if a leader finds it necessary for any reason to remove your student from the trip, you will be notified immediately and WILL NOT be refunded your registration fee. We are so thankful for the support of our church family in helping students be able to go on this trip, with a minimal cost to the student/families. That being said, we also want your student to have their skin in the game to work for what is being given. We also expect participation during youth group on Sunday nights. This is not a summer vacation away from you. This is about their relationship with Christ, their relationships with other students and building a foundation for being the future leaders in our Church. We understand some students may have other church homes and we appreciate and value their participation and desire to be a part of Castleton Students. We appreciate your partnership and understanding in the above.

Student Requirements for Eligibility:
- 2 payments of $100.
- Must participate in all fundraisers - unless arranged prior to the fundraiser with Pastor Anthony.
- Participation in Sunday night Castleton Students meetings.

Registration Fee*

CIY Student Registration This is the first of two non-refundable registration fees that will need to be paid for your student to attend CIY. DISCLOSURE: the approval of your student going on this trip is at will of the leaders. If your student has not met the requirements to be able to go on the trip, they will be removed and there WILL NOT be a refund of registration fee.

$100.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Authorization to Search

As staff and leaders of Castleton Christian Church, we have the right to go through any personal belongings, if we have reasonale suspicion that a student is in possession of any item, substance or material that can cause harm to themselves, or others, or cause a major distraction to themselves or others.

Disclosure:

Castleton Christian Church, its staff or its volunteers will not be held liable for any damages, injury or costs by reason of the conditions of and occurrences while traveling, upon the property or elsewhere while attending CIY.

Signature: By signing and submitting this form, you agree that you are over 18, and you are approving your student to go on the above trip with Castleton Students. You also are in agreement that everything stated in this form is correct and you agree to all terms of payment and terms of the trip. You understand there will be a total fee of $200 per student, $100 due immediately and $100 due prior to the trip. You understand that this is a non-refundable fee. *