CIY Move Registration (June 12-17, 2017)

Registration & Deposit due by: May 10th, 2017

Departure time: 11:00 AM on Monday, June 12th

Return time: 2:00 PM on Saturday, June 17th

(Actual program runs June 12th-16th)

Follow These Directions to Sign Up

(1) Scroll down, and fill out the form below.

(2) Turn in your $50 deposit to the church office.

(3) Fill out the CIY Online Medical Release Form.

(4) Turn in your new North Terrace Medical Release Form. We are required to update these at the beginning of every year to make sure all information is up to date!

(5) Text @NTMove2017 to 81010 to get updates about this event!  

Cost/Financial Assistance

The cost of this event is $299, however we will never allow money to be a barrier. Financial assistance and flexible payment plans ARE available if needed. If you have any questions or would like to seek financial assistance, please contact our student minister:

Stephen Warner (; 740-453-2951, ext. 105)

Student Name *
Student Name
(Grade student is coming out of)
Parent/Guardian Name *
Parent/Guardian Name
Parent/Guardian Phone *
Parent/Guardian Phone