CIY MIX 2025 (Middle School)

July 27-30, 2025
Hope College (Holland, MI)
Deposit: $50 - Full Price: $429

MIX is a 4-day summer event designed for middle school students to know Jesus better, deepen their relationships, and to be sent out to do Kingdom Work. Moments at MIX change lives and could be the most important four days of your student’s calendar. CIY always provides amazing worship, inspiring speakers, and a concentrated time to spend with God and friends. There is just something special about getting out of our routines and into a new environment to really cause us to listen to God intently.

Hebrews 12:1-2: Run with endurance. Keeping your eyes on Jesus.

MS MIX 2025 Registration Form

Student Name

First Name

Last Name

Student Grade

***Please select the grade they will be entering in the Fall*** If you are an adult volunteer, please mark "adult".

Student Gender

T-shirt Size

These are "adult sizes"

Parent/Guardian Name

This will be the person who will serve as the main point of contact for the Student.

First Name

Last Name

Parent/Guardian Phone Number

Used as the first contact, in case of emergency.

(###)

###

####

Parent/Guardian Email

All announcements about fundraisers, camp meetings, etc. will be sent here.

Emergency Contact Name

This person should be different from the main Parent/Guardian, if possible.

First Name

Last Name

Emergency Contact Phone Number

This number will be used if the Parent/Guardian can't be reached.

(###)

###

####

Emergency Contact's Relationship to Student

(parent, stepparent, grandparent, etc.)

Roommate Preference

***This is NOT a guarantee assignment. This is to help us to assign roommates when doing the rooming lists. We will do our best to honor these requests.***

Any daily medication or allergies that we need to be aware of?

Anything else that we need to know about your student?

Contact

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