Learner's Club Registration

May Learner's Club will be offered on Tuesdays only.
This month's topic is:

Camping!
Child's Name*

First NameLast Name
Child's Date of Birth*

MonthDayYear
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email*
Phone Number*

Area CodePhone Number
Allergies, Special Needs, and Additional Details:
Photo/Video: During Learner's Club, photos and/or videos will be taken for use in ministry promotion for HCLC. Names will not be used. If your child cannot be photographed, please send a written request (not on this form) to the Learner's Club teacher. Thank you.
Please type your name in this box for media release.
The price(s) below include a non-refundable 3% convenience fee.

Registration*

TUESDAYS - Camping!$90.00

(5/5, 5/12, 5/19)

Total $0.00