Early Register Date: December 10th, 2017  Price: $100.
Regular Registration Date: January 14th  Price: $120.
$20 deposit is due on or before these registration deadlines to get locked into these rates.

Attendees' Name *
First Name
Middle
Last Name
Student Address *
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Student Grade *
Parent/Guardian Name*
Parent/Guardian Email*
Parent/Guardian Cell Phone Number*
It is ok to communicate through text messaging?*
By submitting this form you are registering your student and giving permission to First Christian Church to take your student to CIY SuperStart on March 16-17, 2018. You also agree to submit your registration payment on or before the registration deadline.