Luckey Baptist Church
Thursday, July 19, 2018
Knowing Christ, Growing Together, Making a Difference for Eternity


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

Online Vacation Bible School Registration Form
Child's Information
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
Please Fill Out Parent Information Completely
Mother's name: 
Address:   City: 
Phone # 
Home Church: 
Father's name: 
Address:   City: 
Phone # 
Home Church: 

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