Breakaway'25 TEEN CAMP Coordinator Sign-Up & Church Code Request

Breakaway'25 TEEN CAMP Coordinator Sign-Up & Church Code Request

This form to filled out by each Church's Breakaway TEEN CAMP Coordinator ONLY please!
If you are looking for the KIDS Camp Coordinator Sign Up, please use this link instead.

Please carefully review our Registration Guidelines before submitting your form.
Contact Information
Teen Camp Coordinator Name*

First NameLast Name
Email*

Confirmation Email
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Church Information
Church City*
Church Name*
Is this an Assemblies of God Church?*

YesNoI do not know
Were you the Teen Camp Coordinator for this church during the previous camp year?*

YesNo
Will you be the Billing Contact as well, or would you prefer another person at your church be the Billing Contact?*

Yes, I will be the Billing Contact as wellNo, I would like someone else to be listed as the Billing Contact
Billing Contact Name

First NameLast Name
Billing Contact Email

Confirmation Email
Camp Information
Please note that both weeks of Teen Camp have reach capacity based on the Group Holds that have already been secured. However, please proceed with filling out this form so that your request can be handled on a first-come, first-served basis as spots do become available.

By continuing to fill out this form, your group can be added to our waitlist. Please be aware that we do release unused spots (April 28th for Teen Week 1 and May 3rd for Teen Week 2). Therefore, if and when spots become available, we will notify you promptly, and your group will have the opportunity to move off of the waitlist.

We appreciate your understanding and flexibility in this matter. Should you have any questions or need further assistance, please don't hesitate to contact us at ilsmonline@idcag.org.
What Week are you Attending?*
Please note that the week you have selected has reached its capacity based on the Group Holds that have already been secured. However, please proceed with filling out this form so that your request can be handled on a first-come, first-served basis as spots do become available.

By continuing to fill out this form, your group can be added to our waitlist. Please be aware that we do release unused spots to waitlisted churches (April 28th for Teen Camp 1; May 3rd for Teen Camp 2). Therefore, if and when spots become available, we will notify you promptly, and your group will have the opportunity to move from the waitlist and receive your church code.

We appreciate your understanding and flexibility in this matter. Should you have any questions or need further assistance, please don't hesitate to contact us at ilsmonline@idcag.org.
# of Students you expect to bring*
Currently, there are only 25 student spots remaining for Week 1 Group Hold. Please adjust your number, OR be aware that you will only be granted the 25 spots, until additional spots open up. Students above the 25 mark will be waitlisted until additional spots become available.
# of Cabin Leaders you expect to bring*
Please avoid intentional overestimation, as it may impact other students' opportunities. You can adjust these numbers (until/unless the week reaches capacity, or your hold is released) by emailing our office. If capacity is reached, any additional students attempting to register with your church code will be added to a waitlist. Once availability is determined (ie. unused spots are released from other churches), students will be moved from “waitlisted” to “registered” status. Being waitlisted is not necessarily a negative thing! It prioritizes students for open spots based on registration dates. Please encourage your students to still complete their registration even if the portal is indicating they will be waitlisted.
Check the above form for accuracy, are you ready to submit?*

Yes, I've reviewed my form for accuracy and I'm ready to submit
After clicking "Submit" below, please wait until you are redirected to the "Thank You" page before closing your browser. A confirmation email will be sent to the email you provided within a few minutes of submission. If you don't see it, check your junk folder. If you still can't find it, please email ilsmonline@idcag.org to confirm that your submission has been received.
Office Use Only
Should be Empty:

Breakaway'25 TEEN CAMP Coordinator Sign-Up & Church Code Request

Contact Information

Church Information

Camp Information