Illumination Station VBS Registration 2026

Children ages 5–14 are invited to join us June 1st–5th for a week of discovering who Jesus really is. Through hands‑on Bible learning, worship, games, crafts, and mixed‑age Crews, kids will explore how Jesus brightens, reveals, and brings hope to our lives.

We’ll end the week with a special VBS Takeover Sabbath on June 6th, where the children will lead the entire worship service.

We’re excited to welcome your child to a Christ‑centered, joy‑filled week of learning, friendship, and fun!

Please fill out the registration form below (one per child).

Illumination Station VBS 2026 Registration Form

Please complete one form PER CHILD.

Company

This field is for validation purposes and should be left unchanged.

Parent Information

Name*

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Home Church

Child Information

Name*

First Last

Age*

Date of Birth*

Last School Grade Completed

Gender*

T-Shirt Size*

Please let us know what size shirt your child wears. Anyone who registers by May 25th will receive a VBS shirt.

What is your child’s dietary requirements?*

Please let us know if your child has any specific dietary requirements.

Does your child require transportation to and/or from VBS?*

Please let us know if your child requires transportation to and from VBS. If they do need a ride, we will send a separate form for this purpose.

Yes

Thank you! Because you indicated that your child needs transportation, a separate Transportation Request & Consent Form has been emailed to you. Please complete it as soon as possible so we can schedule your pick-up and drop-off.

Emergency Contact Information

Name*

First Last

Phone*

Relationship to Child*

Name

First Last

Phone

Relationship to Child

Emergency/Medical Consent

In case of an emergency involving my child, I understand that reasonable efforts will be made to contact me. In the event that I cannot be reached, I give my consent for one or more of the below-mentioned persons to be contacted. Furthermore, I authorize the calling of a doctor/medical service professional(s), and the providing of any and all necessary medical services (including, but not limited to, administering OTC medications and first-aid). I authorize all below-mentioned persons, pastor, Director of Children Ministries, and any adult leadership to make any necessary medical decisions on behalf of my child and in my absence. I request that in my absence the above-named minor be admitted to any hospital or medical facility for diagnosis and treatment. I request and authorize physicians, dentists, and staff, duly licensed as Doctors of Medicine or Doctors of Dentistry or other such licensed technicians or nurses, to perform any diagnostic procedures, treatment procedures, operative procedures and x-ray treatment of the above minor. I have not been given a guarantee as to the results of examination or treatment. Medical providers are requested to hold on making any disclosures in regard to my child’s medical treatment unless; I am present, or a listed emergency contact is present with my child. I authorize the hospital or medical facility to dispose of any specimen or tissue taken from the above-named minor. I assume full responsibility for any and all costs of such treatment. Further, should it be necessary for the participant to return home due to medical, disciplinary, or other reasons, I do hereby assume responsibility for the participant’s transportation home and any related costs.

Please select one of the following:

I give my consent

I DO NOT give my consent

Electronic Signature*

First Last

Health Information

Allergies (Please list any food allergies as well)

Current Medications: (List only medications needed during event time)

Special Needs

MEDIA RELEASE & CONSENT

I understand that some children’s work and images are confidential under state and federal law. However, I desire to allow my child’s image or my child’s work, created while participating in the Emmanuel Seventh‑day Adventist Church Illumination Station VBS program (“Illumination Station” or “Emmanuel SDA” or “Emmanuel SDA Church”), to be displayed publicly. Therefore, I give my full consent for Emmanuel SDA to display my child’s work (including art, photography, video recordings, audio recordings, written work, verbal statements, or web‑based material) and/or child‑identifying content (including audio recordings, photographs, and video images that include my child’s voice or likeness) for instructional, informational, public relations, promotional, and/or publicity purposes related to Illumination Station or other children’s ministry activities. I understand that my child’s work and/or child‑identifying content may appear in Emmanuel SDA publications, Illumination Station–related materials, church news releases or publicity materials (print, audio, or video), public exhibitions of children’s work, or on the official Emmanuel SDA website located at https://emmanuel45.adventistchurchconnect.org. I further understand that my child’s work or child‑identifying content may be used in subsequent years at the discretion of Emmanuel SDA Church and may be rebroadcast, republished, or redisplayed by third parties outside the control of Emmanuel SDA Church. I acknowledge that Emmanuel SDA cannot control or prevent the republication, redistribution, or recording of images, statements, or media by third parties. I acknowledge that my consent to the above conditions is voluntary and given without coercion or duress. I understand that no monetary compensation is being provided for the use of my child’s work or image. I further understand that this consent is binding upon my heirs, successors, assigns, and legal representatives. If I wish to revoke this consent in full, or revoke consent for specific child‑created work or child‑identifying content, I understand that I must provide written notice to: Emmanuel SDA Church Attn: Children’s Ministries Director 1111 Boone Street Cleburne, TX 76031 This release is created pursuant to Texas Education Code § 26.009 and the federal Family Educational Rights and Privacy Act (“FERPA”), 20 U.S.C. § 1232g. I understand that this release does not create or expand any rights to privacy or intellectual property beyond those already provided under state and federal law.

Please select one of the following:

I give my consent

I DO NOT give my consent

Electronic Signature*

First Last

ILLUMINATION STATION VBS 2026 — EXPERIENCE CONSENT

I, the undersigned, being the parent/legal guardian of the aforementioned child, hereby give my consent for their full participation in the Illumination Station Vacation Bible School program hosted by Emmanuel Seventh‑day Adventist Church. This program will take place June 1–5, 2026, with a special VBS Takeover Sabbath on June 6, 2026, held on the property of Emmanuel Seventh‑day Adventist Church in Cleburne, Texas. I agree to indemnify and hereby release Emmanuel Seventh‑day Adventist Church, the Children’s Ministries Director, Lower Division Leaders/Teachers, volunteers, Crew Leaders, and all participating children from any and all liability, claims, or demands for personal injury, sickness, or death, as well as property damage and expenses of any nature whatsoever, which may be incurred by the undersigned or the participant as a result of their involvement in the above‑mentioned event (including transportation to and from the event, if applicable). I certify that my child is physically, mentally, and emotionally fit to participate in all activities associated with the Illumination Station VBS program. Furthermore, on behalf of the participant, I voluntarily assume all risks of personal injury, sickness, death, damage, or expenses arising from participation in this event. Should it become necessary for my child to return home due to medical reasons, behavioral concerns, or any other circumstance, I agree that I or an emergency contact person will be available to immediately return to the premises to pick up my child upon notification. If I wish to revoke this consent at any time, I understand that I must provide written notice to: Emmanuel SDA Church Attn: Children’s Ministries Director 1111 Boone Street Cleburne, TX 76031

Please select one of the following:

I give my consent

I DO NOT give my consent

Electronic Signature*

First Last

CONSENT AGREEMENTS

Digital Signature*

By signing below, I acknowledge that I have read and fully understand the terms of this consent and release of liability form and agree to comply with the guidelines outlined herein.

First Last

Does your child need transportation to/from VBS?*

Please let us know if your child will require transportation to attend VBS.

Yes – Round Trip

Yes – Getting to VBS

Yes – Getting home from VBS

No – I will bring my child(ren)

Unsure at the moment

Thank you for your response! You will be emailed a transportation request form soon!