HCC KiDs Registration
Please register all of your children from birth through 6th grade. Thank you!
First & Last Name of Mom (or Guardian)
Your answer
Mom's Cell
Your answer
First & Last Name of Dad (or Guardian)
Your answer
Dad's Cell
Your answer
Address
Your answer
Email address
Your answer
Emergency Contact Name & Phone #
Your answer
Child 1: First & Last Name
Your answer
Child 1: Birthdate
MM
/
DD
/
YYYY
Child 1: Child's Grade (if applicable)
Your answer
Child 1: Allergies, medical conditions, or special instructions
Your answer
Please choose yes or no for the following:
yes
no
Permission to diaper
Snacks allowed
Do you have additional children that you would like to register? *
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