Log In
Special Needs Pre-Registration
Error
Work Entry
Added: 6/30/2025
Loved Ones First Name
First Name is required.
Loved Ones Last Name
Last Name is required.
Birth Date
Birth Date is required.
Gender
Unknown
Male
Female
Gender is required.
Tell us about your loved one!
Friend Details is required.
Family Address
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
Share diagnoses you may find helpful for us to care for your loved one.
Diagnoses is required.
List any medications you will bring to special needs Sunday morning or events.
1st Parent/Guardian First Name
1st Parent/Guardian First Name is required.
1st Parent/Guardian Last Name
1st Parent/Guardian Last Name is required.
1st Parent/Guardian Phone Number
1st Parent/Guardian Phone Number is required.
1st Parent/Guardian Email
Email address is not valid
1st Parent/Guardian Email is required.
2nd Parent/Guardian First Name
2nd Parent/Guardian Last Name
2nd Parent/Guardian Phone Number
2nd Parent/Guardian Email
Email address is not valid
What is your child's preferred group experience?
Prefers Small Groups
Prefers to be Alone
Eloper/Runner
Doesn't Mind Larger Groups
Prefers to be with Others
Struggles with Transitions (moving from one place to another)
Communication
Non-verbal
Verbal
My Child Uses a Digital Device to Communicate
My Child Uses Sign Language to Communicate
Communication is required.
My child loves...
Music/Worship
Arts & Crafts
Video Games
Being Outdoors
Videos/TV
Classroom
Treasure Class (up to 6 years old)
Bible Buddies (6-12 years old)
Young Leaders (12+ years old)
Classroom is required.
Dietary Restrictions
Gluten Free
Vegetarian
Dairy Free
Peanuts
Other
Restroom Needs
My child is independent in the restroom
My child needs assistance in the restroom
My child wears diapers/pull ups
Restroom Needs is required.
Restroom Permissions
Volunteers are allowed to take my loved one to the restroom
Volunteers are allowed to change diapers/pull ups
Volunteers need to call parent for restroom needs
Restroom Permissions is required.
We love to use pictures from our time together to promote special needs ministry at HCBC. Do you approve of Hill Country Bible Church using photos your child is in to promote our ministry on the HCBC.COM webpage and our social media accounts?
No
Yes
Photo Opt In is required.
Submit