HCC KiDs Registration
I am registering my child for the following activity or activities: (*)




please choose an activity

For AWANA only there is a cost of $25 for the first child in a family and $15 for each additional child in the same family. Note name of child(ren) and AWANA on memo line of check or on front of envelope and place in the locked dropbox located in the lobby to the left of the sanctuary doors.

Parent/Guardian Name (*)

Please let us know your name.
Your Email (*)

Please let us know your email address.
Your Address:

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Contact Phone #

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Child's Name (*)

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Date of Birth (mm/dd/yyyy) (*)

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Allergies or other conditions we should be aware of (ADHD, physical limitations, food reactions, etc)

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Grade:

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Please list the name(s) of up to 3 adults (in addition to the parents listed above) that may pick up your child. Photo ID may be requested at the time of pick up.

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FOR NURSERY ONLY







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