Breakaway'24 TEEN CAMP Coordinator Sign-Up & Church Code Request

Breakaway'24 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.
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, we strongly encourage you to 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. We will notify you once your students move from Waitlisted to Registered status.

By continuing to fill out this form and obtaining a Church Code, your group can be added to our waitlist. Please be aware that we do release unused spots one month prior to the beginning of each week of camp. Therefore, if and when spots become available, we will notify you promptly, and your group will have the opportunity to move from the waitlist to registered status.

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, we strongly encourage you to 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 and obtaining a Church Code, your group can be added to our waitlist. Please be aware that we do release unused spots one month prior to the beginning of each week of camp. Therefore, if and when spots become available, we will notify you promptly, and your group will have the opportunity to move from the waitlist to registered status.

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 approximately one month before your camp week or until the week reaches capacity, whichever comes first, by emailing our office. If capacity is reached, 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 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.
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Breakaway'24 TEEN CAMP Coordinator Sign-Up & Church Code Request

Contact Information

Church Information

Camp Information