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HBC Kids Fall Thrive 2018 Registration
Registration for the 2018-2019 School year!
Email address *
Dad's Name (Last, First) *
Dad's DOB (mm/dd/yy) *
Mom's Name (Last, First) *
Mom's DOB (mm/dd/yy) *
Other (Last, First)
Other DOB (mm/dd/yy)
Child(ren) live(s) with: (check all that apply) *
Required
Family Address *
Child's Name (provide last if different from above) *
Child's DOB (mm/dd/yy) *
Child's Gender *
Child's Age (as of Sept. 2018) *
Child's Grade (as of Sept. 2018) *
Child's Shirt Size (Youth Sizes) *
Allergies / Special Needs:
Other Adults Authorized to Pick Up Your Child (Full Name & Phone Number) Please write NONE if no one else is authorized. *
Emergency Contact Information (Full Name & Phone Number) *
Liability Waiver (you can download the liability form from the website hbcwestminster.com, under Children's Ministry / Thrive)
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