Kids Club Winter/Spring Session 2 - Registration
Wednesday Nights 6:30-8:00pm | Please fill out the following information and click submit at the bottom to complete the registration.
Child's Information: Please complete a separate form for each child you wish to enroll in HTC Kids Club.
Child's Name
*
Child's Home Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Child's Home Phone
*
Child's Date of Birth (MM/DD/YY)
*
Child's School Name
*
Child's Grade in School
*
Please select one option.
Preschool (3-4yrs)
Transitional Kindergarten (TK)
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
Select Option
Preschool (3-4yrs)
Transitional Kindergarten (TK)
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
Club Name
*
Please select one option.
Explorerers: 3 yrs - Transitional Kinder (TK)
Adventurers: Kinder - 2nd grade
Pathfinders: 3rd grade - 6th grade
Select Option
Explorerers: 3 yrs - Transitional Kinder (TK)
Adventurers: Kinder - 2nd grade
Pathfinders: 3rd grade - 6th grade
Child currently lives with:
*
Please select one option.
Both Parents
Mother
Father
Other
Is Child currently attending church?
*
Please select one option.
Yes
Not right now
If yes, where?
Allergies/Medical needs
*
#1 Parent/Guardian Information
Name
*
Email
*
This address will receive a confirmation email
Cell Phone
*
#2 Parent/Guardian Information
Name
Email
Cell Phone
I, the parent/guardian of the above mentioned Child, understand that my son/daughter is responsible for learning and following the rules & regulations created by the church and adult leaders in order to participate in any children’s activities during the dates included on this release form. It is expressly understood by this parent/guardian that the above named minor is in a condition of health that warrants his/her participation in the scheduled activities during the dates included on this release form, and that an adult leader of these activities is hereby granted permission to take the named minor to a medical doctor for examination & treatment of any accident or illness that may arise during any activities attended. In consideration of this acceptance, said church, its agents, and employees are hereby released and relieved from all liability for accident & injury to said minor arising from any and all activities & events for which this release form is applied. I also hereby consent to the use of any video tape, photographs or other visual or audio reproduction in which my child may appear by Harbor Trinity Church. I understand that these materials are being used for promotion of the ministry of Harbor Trinity Church. I release Harbor Trinity Church from liability connected with the use of my child’s picture or voice recording as part of any promotional or recruitment program.
*
Please select all that apply.
I Agree
Submit
Description
Wednesday Nights 6:30-8:00pm
Please fill out the following information and click submit at the bottom to complete the registration.
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