Learner's Club Registration

April Learner's Club will be offered on Mondays & Tuesdays.
This month's topics are:

"Legos" (Mondays) & "Earth Day" (Tuesdays).

Child's Name*

First NameLast Name

Child's Date of Birth*

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*

MONDAYS - Legos$90.00

(4/13, 4/20, 4/27)

TUESDAYS - Earth Day$120.00

(4/7, 4/14, 4/22, 4/28)

Total $0.00

Credit Card Information