2026 VBS ILLUMINATION at First Baptist Church of Lead Hill
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Child Name
*
Child's Age
*
Grade Completed
*
Please select one option.
Preschool
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Other
Parents Names
*
Emergency Contact
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Need to be Pick Up?
*
In addition to parents, who is authorized to pick up your child after VBS?
*
Does your child have any allergies?
*
Email
*
This address will receive a confirmation email
Phone
*
Does your child attend church?
*
Please select one option.
Yes, we attend FBC of Lead Hill
Yes, we attend a different church.
No, we do not attend church.
Submit
Description
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