Central

Valley

North

Register For A Good News Club!

Thank you for being interested and wanting to join a Good News Club. Please fill out the online form below. You will receive an email for your records.Any questions please feel free to email us.

Times Available (Please make a selection)(Required)

Confirm Room with School Office

Parent/Guardian Name(Required)

About Your Children

Add Child's Information(Required)

Use plus sign to the right to add more rows

Child's Name

Grade

Birthdate

Gender

Family Information

Family Email(Required)

Family Phone(Required)

Family Address (Physical address for mailing items to the children)(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Check here to show how your child will get home on club day?(Required)

List any security/custody issues with this child?

PERMISSION FOR PICK UP - in addition to those listed above, the following people are allowed to pick up my child:

List any special needs (ADD, Asperger’s, Dyslexia, etc.)

Child’s Allergies(peanuts, chocolate, etc)

Emergency Contact

Emergency Contact's Name(Required)

Emergency Contact's Phone(Required)

NOTE: On electronic forms, your typed signature has the same effect as your written signature. For your child’s safety, only children with permission from parents may attend. Also, teachers in our clubs have been screened according to the Child Protection Policy of Child Evangelism Fellowship.(Required)

Permission of Photography Consent - OPTIONAL Photography and Video Release (Not required for club attendance) Child Evangelism Fellowship® may, from time to time, document the activities of the ministry with photos or videos. I hereby assign and grant to Child Evangelism Fellowship Inc., its subsidiaries and successors, and assign the unqualified right to the ownership, use and proceeds of all photographs or video of me or my minor child, without reservation or limitation, including use of photographs or video of me or my minor child for, but not limited to, advertising, educational and promotional purposes. NOTE: On electronic forms, your typed signature has the same effect as your written signature.

IMPORTANT: If you miss a required field on this form and are unable to submit your application, please refresh this page and try again by filling out all the required fields as well as the checkbox below.

Your will receive a confirmation email. Please check your email spam folder to approve us as a sender.