Breakaway 2023 Pre-Registration

Breakaway 2023 Pre-Registration

Please read conditions thoroughly before completing.
For a number of reasons, we are adjusting the registration process for camp slightly.

The first reason being, both weeks of our Teen Camps are consistently at capacity and we are trying to create a fair way for churches to ensure all of their students have a spot while still maintaining accountability from the church.

Additionally, adding this process will help us to pull reports and enter payments in a much more efficient manner for the churches as a whole, as opposed to each student individually or by family as we have done in years past.

Finally, while we love our guests from out of state and non-denominational churches, as the Illinois District of the Assemblies of God, we have to give priority to our Illinois AG Churches within reason. This will allow us to guarantee their ability to participate, should they do their part in a timely manner, then fairly give spots to other churches.

Prior to completing this form you will need to know the following:
- How many students you will DEFINITELY bring. This cannot be a guess or an overestimate. This is the guaranteed number of students you will be bringing with you.
- This form is completed by church. You will need to know the church's official name, address, phone number, email. You will need to assign someone who will be the "Financial Contact" for the church in Campwise. This person will have the church linked to their account. Generally, this is the Camp Coordinator. We can add extra staff members to each church for each session.
- The week of camp you plan to attend. Please only complete this form if you are certain which week you will be attending!
If you have any questions about this form, please ask them before submitting the form. If you complete your form and need changes made, please email us at ilsmonline@idcag.org.

Again, ONLY register the number of students you guarantee will be there.

For Kids Camp: Group Hold numbers will be honored until May 15th. After that, any unclaimed spaces will be released to everyone else.

For Teen Camp: Group Hold numbers will be honored until June 15th. After that, any unclaimed spaces will be released to everyone else.

Once your church is registered, we will send the contact you have listed a Group Hold ID. You will have to provide this to all of your attendees as they will need to enter it at the first step of registration.

IL AG churches will be given priority when assigning group holds and have until March 31st to claim the number of spots they need. On April 1st, all other churches will be provided with their Group Hold ID's and confirmation of the number of spots available.

Please fill out a separate form for Kids Camp and Teen Camp.
YesNoI skimmed it and am taking the risk of not fully acknowledging the details to move through this form quickly...

Name of the person completing this form:*

First NameLast Name
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If not, please provide the name for the Camp Coordinator:*

First NameLast Name
Coordinator Email*

Confirmation Emailexample@example.com
Coordinator Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Coordinator Home Address (for Campwise)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Church Name:*
Church Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Church Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
YesNo
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Additional Contact Name*

First NameLast Name
Additional Contact Email*

Confirmation Emailexample@example.com
Additional Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Additional Contact Role for Camp*
i.e. Financial Representative, Assistant Coordinator, etc.

Kids Week 1: June 12-16, 2023Kids Week 2: June 19-23, 2023Teen Week 1: July 10-14, 2023Teen Week 2: July 17-21, 2023
Teen Week 1 Group Holds are full. No additional Group Holds can be issued for this week of camp. If you have any questions you can contact ISM at ilsmonline@idcag.org. Thank you.
Please provide the guaranteed number of students:*
Please provide the number of female counselors you plan to bring:*
1:7 counselor-to-student ratio, 2:6 for 2nd & 3rd grade
Please provide the number of male counselors you plan to bring:*
1:7 counselor-to-student ratio, 2:6 for 2nd & 3rd grade

Terms and Conditions:

In completing this form and signing below I confirm the information provided is accurate to the best of my knowledge and my church will be held accountable for fulfilling the financial responsibility for the spots which have been requested on their behalf. Furthermore, I understand this submission does not contradict the tiered pricing based on deadlines set forth by Illinois Student Ministries and each student will be charged from the tier schedule based on the time of their online registration and the church's compliance with deposit deadlines found on the Illinois Student Ministries website and in the Camp Coordinator Manual. I understand if my students do not register prior to the deadline given for the Group Hold there is no guarantee their spot will be held and it may be released to outside groups or the general public. I acknowledge that, if there is an unforeseen trend in registration in either direction I will contact the Illinois Student Ministries office as soon as possible in attempt to rectify and prevent any complications.
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You must read the Terms and Conditions in their entirety to submit this form. Please do so now.
Please sign that you agree to the Terms and Conditions*

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