"Why Not Wednesdays?" WEBC KIDS Registration
Event Timing: Wednesdays @ 6:30-8:00pm
Event Address: West Edgecombe Baptist Church
                          13821 NC 43 N
                           Rocky Mount, North Carolina  27801
Contact us at Children@westedgecombebaptist.com
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Child's First Name *
Child's Last Name *
Gender *
Birthdate *
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Current Grade (if applicable)
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Address, City, State, Zip Code *
Parent's Name and Phone Number *
Parent or Guardian's Email *
Emergency Contact's Name and Phone Number *
Does your child have any allergies? *
If you checked "YES" to allergies, please explain here:
Is there anything additional we need to know about your child?
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