Ordination | WALKERS/TODDLERS | Nursery Registration

Child Information

Name

Birthdate (MM/DD/YYYY)

Allergies

Special Needs

Are you registering your child for HCC Children's Programs for the first time?

Yes No, my child has attended HCC Children's Programs previously

Parent Information

Parent's Full Name

This address will receive a confirmation email

Please provide the phone number at which we can reach you during the ordination.

Cell Phone

Will you be picking up your child personally?

Yes No

If not, who will be picking up your child?

Phone of pick-up person (xxx-xxx-xxxx)

Description

September 10, 2022 (3:00pm)

Childcare for children ages 1-2.

Class capacity: 7