Burns Elementary-Middle School                                   Zoom Good News Club Registration Form

Please submit one child's name per registration form. Thank you for your cooperation.

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Please type child's First and Last name. Example: Kayla Brown *
Please type the name of the school your child is attending. *
Please type your email. *
Please type First name, Age, Grade, and Teacher's Name of your child. Example: Kayla, 8, 3rd, Miss Telley *
Please type the First and Last Name of Parent(s) / Guardian(s).        Example: Shawn Brown, Mia Brown *
Please type your Cell Phone Number.   Example:  Shawn Brown-313.109.7221;      Mia-313.997.8675 *
Please type your Address.   Example: 1234 Patton, Detroit, MI 48236 *
Please list any  Allergies or Learning Disabilities. Example: Kayla -None  or Michael-peanut butter + ADHD *
By typing your name electronically on this Good News Club Registration Form, you are agreeing that your electronic signature is the legal equivalent of your manual signature. *
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