2022 BreakAway

Please fill out this form and click submit.
Please complete this form to be registered for BreakAway. BreakAway is scheduled for June 17th - June 19th at Pine Creek Camp. All persons attending in your family must register to be elible to attend. 
If you have questions about the event please contact Janee LaFuze at janee@andrew-umc.org.

Note: After completeing this registration there will be a link to continue and complete our Family Ministries Release & Waiver. This MUST BE completed for minors to complete your registration. If you have already completed this form for another event this calendar year, you do not need to resubmit the form.
Child 1

Please fill out a registrations section for each person attending within your family. 
 
 
 
 
Child 2

 
 
 
 
Child 3

 
 
 
 
Child 4

 
 
 
 
Adult 1 Information

 
 
 
Adult 2 Information

 
 
 
Payment

Please choose a method of payment below. Payment for BreakAway is due by June 10th at noon.
Cost/Family: $50.00 Make payment online here.
Please select one option.
Continue to Release & Waiver Form

https://standrew.breezechms.com/form/b36099858

P
lease click the link above to continue and complete your registration. All minors adding must have this on file. You shall recieve a confirmation email shortly after completing this form and submitting.
(Adult attendees do not need to complete this step and may finish here)

Description

Please fill out this form and click submit.