Breakaway registration form


Fri, Mar 4 at 3 pm-Sun, Mar 6 at 5 pm

$169 Includes conference, concert, 2 nights at Hyatt, breakfast, snacks, boardwalk and more!  ($260 value)

Sign up ASAP.  Limited Space Available.     Contact Cindy @ 301-606-6762 or 


Behavior                                                                 Safety

Respect peers and social boundaries.                   No drugs, alcohol, violence. Obey leaders.

No Phones.

Use appropriate language/gestures.

Share responsibilities; observe group time.

Student must agree to all rules and consequences established by Adult Leaders including NO CELL PHONES in order to register and attend.


My child named below has permission to attend the BREAKAWAY CONFERENCE in Ocean City, MD, sponsored by YFCCM and Campus Life on Fri, Mar 4, through Sun, Mar 6 2022.  I agree to all transportation arrangements, emergency medical decisions if I cannot be reached and rules established by Campus Life leaders. I agree to allow YFCCM and Campus Life to use photos of my child for websites and media promotions. Submitting this form means the same as giving my signature.