Holland Heights Church Student Registration 2021-2022
You may register up to 5 children using this form. There are *seven* sections to this form and if you are registering less than 5 children, please continue to hit NEXT until you get to section *six*, the Parent Information Section, to finish filling out the form. Upon successful completion of this registration form, you will receive a screen telling you that your response has been recorded. If you are registering more than 5 children, please complete and submit another response. If you have any questions, please contact Sara Arent at 616-396-5988.
Sign in to Google to save your progress. Learn more
Student's Personal Information - Child 1
What program are you registering this student for? *
Student's First Name *
Student's Last Name *
Date of Birth *
MM
/
DD
/
YYYY
Age *
Gender *
Required
Can your child swim?
Student's School
Student's Grade *
Student's Phone Number
(xxx-xxx-xxxx)
Student's Email Address
Special Circumstances
Are there any special circumstances or medical conditions we should be aware of (allergies, disabilities, family situations, etc.)?
Special Circumstances
Clear selection
If yes, please explain
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Holland Heights CRC. Report Abuse