Breakaway'24 KIDS Coordinator Sign-Up & Church Code Request

Breakaway'24 Kids Coordinator Sign-Up & Church Code Request

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

First NameLast Name
Email*

Confirmation Email
Phone Number*
Please enter a valid 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 Kids 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
What Week are you Attending?*
# of Students you expect to bring*
# of Cabin Leaders you expect to bring*
Please avoid intentional overestimation, as it may impact other students' opportunities. You can adjust these numbers until approximately one month before your camp week or until the week reaches capacity, whichever comes first, by emailing our office. IF capacity is reached (which is not likely for Kids Camp) students attempting to register will join 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 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.

While we do not foresee capacity issues for Kids Camp, if, for any reason, we were to reach capacity, any unused spots would be released approximately one month before the camp week's start date to allow waiting students an opportunity to register. However, it's important to note that we do not anticipate this issue for Kids Camp, making this scenario unlikely.
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.
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Breakaway'24 Kids Coordinator Sign-Up & Church Code Request

Contact Information

Church Information

Camp Information