Good News Club Registration

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January 31st-May 16th (3:30-5:00pm)

Email *

Names/Grades of all children you are registering

Example: John Smith (5th Grade), Ashley Smith (Pre-K)

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.

Yes

Clear selection

What school does your child attend? *

Lakeview

North

Tussing

LCA

Homeschool

Other:

Please list any custody issues or anything important we should know (ADHD, Asperger's, ADD, etc.)

Please list your child's homeroom teacher

Please list who has permission to pick-up your child from GNC (in addition to parents, guardians, and emergency contacts)
*

Parent/Guardian full name *

Phone number for parent/guardian *

Emergency contact name *

Emergency contact number *

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.
*

I agree

PHOTO RELEASE: I grant permission for MPBC to use my child's picture to help promote GNC and document the activities of the club.
*

I agree

Please do not take any photos

Do you have a church home? *

Yes

We are currently looking for a church

If you have a church home, where do you go?

Is either parent in the military? *

Yes

Full address *

Send me a copy of my responses.