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UCYPAA 2024 Registration
May 24-26, 2024

Camp Kiesel in Huntsville, UT
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Email *
First and Last Name *
Cell Phone Number
 *
City, State *
Participant *
Sobriety Date
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DD
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Are you staying in a tent? Or would you like to stay in the bunkhouse?
 *
If you have a group of people that would like to share a room (we have 9 rooms with 8 bunks) please provide one contact person. 

Contact Lisa with questions at 315-576-0413
We encourage carpooling! Are you planning to:
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Dietary restrictions *
We are taking payment on vemno @william-haney-10.

Pre-registration is $40! Price will increase at the door.

Enter your email in the venmo comment or put your venmo handle below so we can connect registration to your payment. Registration is not refundable.
 *
I would like to donate a scholarship. Please just pay for two (and include donation in venmo comment)
Are you interested in volunteering during the event? 
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Let us know of any accommodations you need! (ex: interpretation, etc.) 
Is there anything else you want us to know?
A copy of your responses will be emailed to the address you provided.
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