COTH 2026 Registration Form

Registration Form: City on the Hill July 19-25, 2026

Applicant must be a Christian youth 15 – 18 years of age (unless otherwise approved by the conference administrator), be enrolled in high school (or recently graduated), or currently being home schooled at the high school level; and must desire to learn how to apply their faith to become a leader among their peers; Completed application with follow-up forms must be submitted or postmarked by May 31, 2026 (April 30, 2026 for early registration).

Cost:
$575 (Jan 1 - April 30)
$125 registration fee + $450

$625 (after May 1)
$175 registration fee + $450

This online form is the first step in completing your full application for City on the Hill.

**If you are receiving a scholarship from another person or organization, do not use this form, but call us at (717) 545-0600.**

Student Information

Student First Name

Student Last Name

Student Email Address

Student Mailing Address

Student Mailing City

Student Mailing State

Student Mailing Zip

Student Birthdate

Student Age

Student T-Shirt Size

Student SexMaleFemale

How did you hear about City on the Hill?

Parent Information

Parents' Full Names

Parent Email Address

Parent Phone

COTH Registration Fee

Interested in Scholarship Information (first time students only)NoYes

Your Information

I am donating as a...

Organization Name

First Name

Last Name

Country

Address 1

Address 2

Postal Code

City

State/Province

Phone Number

Email Address

Yes, I would like to receive email communications.

Payment

Promo Code

Card Number

Card Type

Expiration Month

Expiration Year

Name On Card

CVV Code

Account Number

Routing Number

Name On Account

Account TypeCheckingSavings

Billing Address 1

Billing Address 2

Billing Postal Code

Billing City

Billing State

Billing Country

*Registration Fee is non-refundable.
**Refund Policy:

If you register by the April 30th deadline and cancel before the May 31st deadline - full refund
No refunds for cancellations after May 31st.

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