camper details

Please complete a separate form for each young person you are registering.

Registration is now closed.

Camper’s First Name

Camper’s Last Name

Date of Birth

Day

Month

Year

Current School Year (as at January 2026)

Gender

Address Line 1

Address Line 2

Town/City

Area/Country

Is this the young person's first time at the CY Camp?

Does this young person receive additional support in and/or out of school, and/or have a diagnosed condition or any health/medical needs of which we should be aware?

If yes, please give brief details of the support/diagnosed condition/health needs below. We may contact you for more information:

Does this young person have any dietary requirements?

If yes, please detail the dietary requirements below:

Home Church (if applicable – write “Not applicable” if none)

Emergency Contact 1.

First Name

Last Name

Relationship to Camper

Phone Number

Emergency Contact 2.

First Name

Last Name

Relationship to Camper

Phone Number

Registration Fee

£250

click on make payment button to complete payment

camper details

Emergency Contact 1.

Emergency Contact 2.

3rd - 7th Aug