Example: John Smith (5th Grade), Ashley Smith (Pre-K)
*
Your answer
Does your child need a ride from school to church? Please only mark yes if your child can only attend if they get transportation (seating is limited).
We do NOT provide transportation from church to home.
Clear selection
What school does your child attend? *
Please list any custody issues or anything important we should know (ADHD, Asperger's, ADD, etc.)
Your answer
Please list your child's homeroom teacher
Your answer
Please list who has permission to pick-up your child from GNC (in addition to parents, guardians, and emergency contacts) *
Your answer
Parent/Guardian full name *
Your answer
Phone number for parent/guardian *
Your answer
Emergency contact name *
Your answer
Emergency contact number *
Your answer
My child is allowed to attend the January 31st-May 23rd Good News Club. I understand it is my responsibility to pick up my child at 5:00PM and failure to do so will jeopardize my child’s continued participation. *
PHOTO RELEASE: I grant permission for MPBC to use my child's picture to help promote GNC and document the activities of the club. *