Hill City Kids Ministry Child Form

Sunday 12pm PST | Please fill out this form and click submit.

This form will be used to register your child(ren) into the Hill City Kids Ministry. Age limit for this ministry is 3-11

Child Information

Name

*

Birthday

*

Grade

*

Parent Information

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Child Learning Information

We understand that some children learn at a different pace and may have some physical or mental disablities that may cause learning to be difficult. We want to accomodate each child with teaching them in the a way that best fit their learning style.

Does your child have a learning or physical disability?

*

Please select one option.

Yes No Unsure

Does your child have issues with loud noises?

*

Please select one option.

Yes No Option

Does your child have sensitivity to light?

*

Please select one option.

Yes No

Does your child have food allergies?

*

Please select all that apply.

Yes No

If yes, please list. If not, please skip this response

Parent Volunteer

Are you interested in becoming a volunteer?

*

Please select one option.

Yes No Not Sure

Are you open to donating to the ministry?

*

Please select all that apply.

Yes No Not sure

By donating today, your donation will help with purchasing teaching materials for the teachers and craft items for the kids. If you would like to donate items needed, you can send them to: 305 W Torrance Blvd, Ste A Carson Ca 90745

We thank you in advance for your donations.

Hill City Kids Funds

($0) ($10) ($20)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Sunday 12pm PST

Please fill out this form and click submit.

Please Fix the Following

Close