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Winkler's Grove Baptist Church

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Childrens Wavier 2023

Child's First Name

Child's Last Name

Parent or Guardian Email

Child's Date of Birth

Child's Cell Phone

Street Address

City

Postal / Zip code

Region/State/Province

List all Medications with MG and Dosages

List any allergies, medical problems, or any other important information we may need to know on our trips for 2023.

Parent or Guardian Signature

Emergency Contact

Insurance Company

Insurance Number

I declare that the info I’ve provided is accurate & complete

Your Signature

Thanks for submitting!

SERVICES

Sunday Morning Worship
10:00 AM

Sunday Evening Cellar Dwellers
3:00 PM - 4:00 PM

Sunday Evening Worship
4:00 Pm

Wednesday Evening Cellar Dwellers
6:00 PM - 7:00 PM
Wednesday Night Worship 7:00 PM

BIBLE AND STUDY HOUR

10:00 AM TUESDAYS

6:30 PM TUESDAYS

PRAYER REQUEST

DIRECTIONS

3320 9th Avenue NW

Hickory NC, 28601

CALL US

828-324-7267

Email: wgbc@winklersgrove.org

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