VBS – Homeland Seventh-Day Adventist Church

This years Vacation Bible School (VBS) theme is “Dare to Be” and is a free event for children ages 4-12.

Date: July 26-30

Time: 5:00 to 8:00 pm

Location: Homeland Seventh-day Adventist Church

VBS 2026 Pre-Registration

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

Last Name*

First Name(s) and Age(s)*

Write the names of all your children who will attend and their ages – 1 per line

Parent/Guardian Name(s)*

Who Will Be Picking Them Up*

Parent(s) listed above

Other

If someone else please include their full name and phone number.

Parent Home Address*

Street Address Address Line 2 City State ZIP Code

Parent Phone Number (s)*

Parent(s) Email Address(es)

List Medical Problems*

One children per line

List Allergies*

One child per line

Consent*

I agree to the media and medical release and policies.

Consent and Release: I hereby grant The Homeland Seventh-day Adventist Church the right and permission to use photographs and/or video recordings of me or my child(ren) on [July 26 to August 1] at the Homeland Seventh-day Adventist Church.

These materials may be used in various publications, public affairs releases, recruitment materials, broadcast public service announcements, or for other similar purposes.
I understand and agree that these materials will become the property of Homeland Seventh-day Adventist Church and will not be returned.

I hereby authorize Homeland Seventh-day Adventist Church to edit, alter, copy, exhibit, publish, or distribute these materials for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein me or my child(ren)’s likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph or recording.

Release of Claims: I hereby hold harmless and release and forever discharge Homeland Seventh-day Adventist Church from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

I/We, the undersigned, are the parent(s)/guardian(s)of the above named child/children and I/we agree, in taking advantage of the child care services provided by Dare to Be Vacation Bible School (DTB) to release and hold harmless DTB, its directors, offices, employees and consultants from any and all claims, demands, suits, cost, and charges in connection with or arising out of provision of the child care services, including, but not limited to, bodily harm or injury to my/our children, except only for loss, harm or injury occasioned by gross negligence or intentional misconduct by DTB. We/I hereby grant permission for DTB and its personnel full authority to take whatever actions they deem necessary regarding my/our child’s health and safety in the event I/we cannot be reached or in the situation where time is of the essence; and fully release DTB and its personnel from any liability in connection with those decisions. I/we grant permission for emergency treatment by a rescue squad, private physician and/or hospital or emergency health care facility staff, if needed. I/we acknowledge that DTB will take any such action in the best interest of my/our child and DTB will report such action to me/us as soon as possible.