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1850 East Avenue R
Palmdale, CA
(661) 273-4424
 

Hands-God

Hands-People

Hands-Ministry
Sunday
9:00am
Worship 
Kid's Programs: HCC Kids (0-6th Grade)
10-10:40
Coffee & Fellowship
10:45am
Worship
Kid's Programs: HCC Kids & Jr./Sr. High

 
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HCC Kids Information Form
HCC Kids Information Form
* Required
Today's Date: *
 
Child's First and Last Name *
 
Child's Grade Level *
Nursery
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
 
Age *
0-1yr
2
3
4
5
6
7
8
9
10
11
12
 
Birthday (please enter as mm/dd/yyyy) *
 
Medical or Physical condition: *
 
Allergies (food, environment, etc): *
 
Any Special Instructions? *
 
Do you have any special concerns that we may help with?
 
PARENT INFORMATION
 
Parent/Guardian #1 - first and last name *
 
Relationship to child: *
Dad
Step-Dad
Mom
Step-Mom
Grandma
Grandpa
Aunt
Uncle
Guardian
Foster Parent
 
Parent/Guardian #2 - first and last name
 
Relationship to child:
Dad
Step-Dad
Mom
Step-Mom
Grandma
Grandpa
Aunt
Uncle
Guardian
Foster Parent
 
Home Address: *
 
Home Phone: *
 
Cell Phone:
 
Email:
 
Additional Information:
 
 
Please fill out a form for each child in your family. Thank you.
Last Published: May 22, 2008 2:38 PM
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