Illumination Station VBS 2026 Registration

Illumination Station VBS 2026 Registration

VBS is available for children who are entering Kindergarten to 5th grade.
How many children are you registering?
Child Information
First Child
Child's Name

First NameLast Name
Child's Birth Date

MonthDayYear
Last Grade Completed
Does the child attend Sunday school anywhere?
Where?
Medical or other information we may need to know about the child (including food allergies).
Second Child
Child's Name

First NameLast Name
Child's Birth Date

MonthDayYear
Last Grade Completed
Does the child attend Sunday school anywhere?
Where?
Medical or other information we may need to know about the child (including food allergies).
Third Child
Child's Name

First NameLast Name
Child's Birth Date

MonthDayYear
Last Grade Completed
Does the child attend Sunday school anywhere?
Where?
Medical or other information we may need to know about the child (including food allergies).
Fourth Child
Child's Name

First NameLast Name
Child's Birth Date

MonthDayYear
Last Grade Completed
Does the child attend Sunday school anywhere?
Where?
Medical or other information we may need to know about the child (including food allergies).
Child Release Information
Parent/Legal Guardian Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Names of Persons to which the child (children) may be released to each day after VBS (Please provide at least two)

First NameLast Name
Phone Number

Area CodePhone Number
Full Name

First NameLast Name
Phone Number

Area CodePhone Number
Are there any persons to which the child (children) may NOT be released to?
Who may you child (children) NOT be released to?
Emergency Contact 1 (other than parent/guardian listed above)

First NameLast Name
Emergency Contact 1 Phone Number

Area CodePhone Number
Emergency Contact 2 (other than parent/guardian listed above)

First NameLast Name
Emergency Contact 2 Phone Number

Area CodePhone Number
Media Release
By clicking the box below, I hereby Give Permission for photographs and/or video in which my child appears in to be used by the church in printed and/or electronic media, including the church's website.
By signing this form, I acknowledge that no medical personnel will be present during VBS and I accept responsibility for my child’s medical needs while on site. Please type Y in the box and sign below
Please Provide Your Signature either Text or Stylus
Should be Empty:

Illumination Station VBS 2026 Registration

Child Information

First Child

Second Child

Third Child

Fourth Child

Child Release Information

Media Release