Loved Ones First NameFirst Name is required.

Loved Ones Last NameLast 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.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?My child loves...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.