VBS Registration
June 10th - June 14th 5:30 PM - 8:00 PM
Kindergarten - 5th Grade
Wytheville Baptist Church, 205 Church Street, Wytheville, VA 24382
Contact us at (276) 228-3712
Child's Name *
Your answer
Parent/Guardian's Name *
Your answer
Address *
Your answer
Home/Cell Number *
Your answer
Work Number
Your answer
Email
Your answer
Child's Age *
Your answer
Grade, Fall 2018 *
Your answer
Emergency Contact #1 (Name and Phone Number) *
Your answer
Emergency Contact #2 (Name and Phone Number)
Your answer
Medical/Special needs and information we need to know.
Your answer
Who may pick your child up at the end of each day? *
Your answer
May we have your permission to photograph your child? *
Do you attend Sunday School, if so where?
Your answer
Does your child need transportation? *
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