Illuminate Conference 2025

Illuminate Conference 2025

NOVEMBER 7TH-8TH
Illuminate Conference Registration Form

5yr Anniversary

We are so excited that you will be joining us this year at Illuminate Conference 2025! Our final lineup will be announced shortly.

COST $50

Includes:

Food, conference swag, and much more

Friday 11/7 - 5p-10p

Saturday 11/8 - 8:30a-7p

**Hotel is not included but can recommend and assist in travel arrangements**

Worship, light wars, outreach and more to be announced!
STUDENT NAME*
DATE OF BIRTH*

MonthDayYear
Date
Shirt Size*
ADDRESS*
PARENT/GUARDIAN NAME
PARENT/GUARDIAN CELL PHONE*
Format: (000) 000-0000.
Church Name
PARENT/GUARDIAN EMAIL
example@example.com
STUDENT PHONE NUMBER
STUDENT EMAIL
example@example.com
As a parent or guardian of the above student I hereby grant my permission for my child to participate in the activities of Illuminate Student Ministry of Crossings Community Church. My child has permission to be transported to and from the special activities organized by Illuminate Student Ministry. I understand that neither Crossings Community Church nor any of its agents are responsible for any injury sustained by my child.
PARENT/GUARDIAN/LEADER SIGNATURE*

Clear
As a parent or guardian of the above student I do herewith authorize the treatment by a qualified and licensed medical doctor of my child in the event of a medical emergency which in the opinion of the attending physician may endanger impairment or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me. I understand that any medical expenses are the responsibility of the participant and their insurance carrier. I hereby grant permission for non-prescription medications to be given, if deemed appropriate.
MEDICAL/HOSPITAL INSURANCE CARRIER
NAME OF POLICY HOLDER
RELATION
POLICY NUMBER
GROUP NUMBER
SIGNATURE OF PARENT/GUARDIAN OR LEADER*

Clear
DRUG ALLERGIES
OTHER ALLERGIES OR HEALTH PROBLEMS
514 Walden View DriveSanford, FL 32771 407.324.5433 www.crossings.cc

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Illuminate Conference

Registration fee

$25.00

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$ Free Quantity

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$0.00

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