Learner's Club Registration January 2025

Learner's Club Registration

January 2025
Learner's Club will be offered on Mondays and Tuesdays.

This month's topics are:
Monday: Space
Tuesday: Birds

You can choose one or both options at the bottom of this form.
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 prices below include a non-refundable 3% convenience fee.

Registration*

MONDAYS - Space$90.00

(1/6, 1/13, no class 1/20, 1/27)

TUESDAYS - Birds$120.00

(1/7, 1/14, 1/21, 1/28)

Total $0.00