Enroll Now
Step One – Fill Out the Membership Card
(Emergency contacts must be two people OUTSIDE of the home – parents/guardians are contacted first)
Step Two – Choose a Site’s Enrollment Agreement
(Last Page Signed and Dated)
Step Three – Gather Additional Information
Latest Shot Record – Signed by Physician
Latest Physical – Signed by Physician
Child Identification Information (Birth Certificate, Passport, etc.)*
*This item will not be kept on file, just recorded by staff for licensing purposes
OR
Stop by our offices at 885 Clinton Avenue, Bristol, VA 24201