Register by March 2nd and receive the discounted rate of $30 and a FREE event t-shirt

We are thrilled to have you register for BREAKING AWAY. Before you begin, please read through our registration policy and have payment information ready for deposits. When you're ready, click below to begin the registration process by clicking on the "button" below. Early registration (and the FREE t-shirt) ends on March 2nd, 2016. 

**If you are a parent registering your student, please contact your church directly to sign up.**

HOW TO REGISTER your group

  • Fill out the form below and submit.

  • Mail check (payable to Wabash Conference) to Pastor Jeremy at Light and Life Church

    • 8264 E County Road 100 S Avon, IN 46123

  • Print out medical release forms for each student and bring completed forms with you to the event. 

Church/Group Information
Church Name *
Church Name
Church Phone *
Church Phone
Church Address *
Church Address
Youth Pastor/Leader *
Youth Pastor/Leader
Small, Medium, Large, X-Large, 2X-Large, and 3X-Large are available