Breakaway'19 Kids Camp Coordinators
This form to filled out by each Church's Kids Camp Coordinator ONLY please!
*
indicates required
Name:
Email:
Comment:
Email Address
*
First Name
*
Last Name
*
Phone Number
Church Name
*
Church City
*
Week of Camp Attending
*
Week 1 - June 10-14
Week 2 - June 17-21
Undecided at this time
Approx. # of Male Students:
*
Approx. # of Male Adults:
*
Approx. # of Female Students:
*
Approx. # of Female Adults:
*
