Luckey Baptist Church
Thursday, August 17, 2017
Knowing Christ, Growing Together, Making a Difference for Eternity
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Fun Maker VBS Registration

 

Transportation available upon request by calling Dennis at 636-208-2432


Online Vacation Bible School Registration Form
 
Child's Information
 
Name:  
                                                               
 Address:    
 
City:   ZIP: 
 
Child's Birth date: 

Type in one of the following in the Age/Grade Box:
 
 3 years-potty trained
4 years old
K-6th Grade
 
Age/Grade: 
 
 
 
 
Please Fill Out Parent Information Completely
 
Mother's name: 
Address:   City: 
Phone # 
Home Church: 
 
Father's name: 
Address:   City: 
Phone # 
Home Church: 
 
EMERGENCY CONTACT

Parent/Guardian contact in Case of emergency: 
 
Phone#:  Other phone: 
 
Allergies or medication we should be aware of: