Breakaway Camp Staff Application

2025 Camp Staff Application

First time applying for Breakaway staff?

That’s great! Fill out the application below to get started. Thanks, and we’re are looking forward to a fantastic summer!

Returning to the Staff?

Click the button below to fill out a short form to update your application.

Returning Staff

"*" indicates required fields

Step 1 of 8

Personal Information

Name*

First Middle Last

Date of Birth*

Permanent Home Address*

Street Address City State ZIP Code

Cell Phone*

Email*

Marital Status*

Single, Never Married

Married

Engaged

Wedding Date

School Mailing Address

Street Address City State ZIP Code

Last Day of School

Where can we find you on Instagram?*

If you don't have an account, reply with N/A

Where can we find you on Facebook?*

If you don't have an account, reply with N/A

Where can we find you on Twitter?*

If you don't have an account, reply with N/A

For which camp(s) are you applying/available*

Check all that apply

Camp 1: June 2-6, 2025

Camp 2: June 9-13, 2025

Camp 3: June 16-20, 2025

Camp 4: June 26-28, 2025

What size t-shirt do you wear?*

Family Information

In case of emergency, please notify:

Name*

First Last

Address*

Street Address City State ZIP Code

When you discussed your desire for this summer ministry with your parents, they were:*

In Favor

Opposed

Indifferent

Church Information

Present Church Membership (Church Name)*

Church Location*

City State

How long have you been a member?*

Pastor's Name*

First Last

Are you currently attending a different church?*

Yes

Name of Church

Church Location

City State

Do you attend church on a regular basis?*

References

Please give name and complete mailing address for each requested reference. Please let these references know that I will be contacting them.

Reference 1

Pastor, College Pastor, Person on Staff

Reference 1 Name*

First Last

Reference 1 Church Name*

Reference 1 Church Address*

Street Address City State ZIP Code

Reference 1 Phone*

Reference 1 Email*

Reference 2

Sunday School Teacher or Church Leader

Reference 2 Name*

First Last

Reference 2 Church Name*

Reference 2 Address*

Street Address City State ZIP Code

Reference 2 Phone*

Reference 2 Email*

Reference 3

BCM Director or Church Leader

Reference 3 Name*

First Last

Reference 3 Address*

Street Address City State ZIP Code

Reference 3 Phone*

Reference 3 Email*

Reference 4

College Professor/High School Teacher

Reference 4 Name*

First Last

Reference 4 Address*

Street Address City State ZIP Code

Reference 4 Phone*

Reference 4 Email*

Due to the unique and special nature of Breakaway Camps, staff members are expected to exhibit conduct and actions that project an image consistent with the expressed purpose and mission of Louisiana Baptists. It is therefore imperative that staff favorably represents Breakaway Camps. Conduct which brings embarrassment to Breakaway Camps or impedes its credibility with constituents is unacceptable. Conduct or other actions inconsistent with expectations of denominational employees and other Christians is unacceptable. Similarly, conduct or other actions perceived as inconsistent are unacceptable. Examples of such conduct are involvement with alcohol, illegal drugs, pre-marital or extra-marital sex, homosexuality, cohabitation apart from a marriage relationship, and outside interests and pursuits which would be considered incompatible with the mission of Breakaway Camps. Breakaway Camps has the right and responsibility to do everything possible to ensure the purpose and mission of Breakaway Camps continues and is not impeded upon by unacceptable behavior on the part of its staff. Consistent with this purpose, Breakaway Camps’ policy is to ensure all applicants and staff behavior meets Breakaway Camps’ standards of acceptable conduct. As a part of this policy, an individual’s current and past conduct is reviewed. Therefore, please respond accordingly to the inquiry below. A “yes” answer does not automatically disqualify you from further consideration for staff, as each individual’s circumstances are reviewed.

Have you ever been convicted of a felony?*

Yes

Have you ever been convicted of child abuse or a crime involving a minor?*

Yes

Do you currently have any lifestyle, conduct or activity which might project a negative image on Breakaway Camps or impede its credibility with its constituents as referenced above?*

Yes

Breakaway Camp Staff Application

Breakaway Camp Staff Application

2025 Camp Staff Application

First time applying for Breakaway staff?

Returning to the Staff?

Personal Information

Family Information

Education

Church Information

Experience

Indicate Experience in Each Category:

Language/Proficiency

References

Reference 1

Reference 2

Reference 3

Reference 4

Personal Sketch

Details for Background Check

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