Good News Club Permission Form 
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Celebration Baptist Church is delighted to offer a free, exciting, fun-filled weekly Good News Club ® for...

Who: All 1-5 graders                                                                                             
When: Thursdays, February 20 - April 3. After school until 5:30 PM.               **** Only on full days of school ****        We will not meet on March 20.

Where: Celebration Baptist Church
(7202 E 9th St. N - corner of 9th and Armour)

Celebration is happy to offer an after-school Good News Club ® (GNC) for students this fall for four key reasons:

To give children the hope of Jesus Christ for living in a dangerous and hopeless world; To help children be ready for the future; To connect with our community (we love our neighbors at Price-Harris); and To provide a safe, structured, positive, and fun place for children (regardless of religious background) to go after school. GNC teachers are specially trained Christians who are concerned for the wellbeing of your child. All club workers go through a background screening process that includes a national criminal background check as required by the Child Protection Policy of Celebration Baptist Church as well as Child Evangelism Fellowship®.
                                                                                                              
Check out www.celebrationbaptist.org ,  www.CEFonline.com and  www.GoodNewsClub.com 
We look forward to a great time at Good News Club!

Walking to Celebration Baptist Church: Each Thursday after school, students will meet in a designated area at Price-Harris. Then, club leaders from Celebration will walk with the children to the church located across the street from the school at the corner of 9th and Armour. 

Picking up Instructions: When picking up your child, please park in the main parking lot located on the north side of the church building and enter through the double doors under the white porch with black railing. When you come into the building, be prepared to show your photo identification. Please note that we will contact you or your emergency contact if someone you have authorized cannot provide photo identification or if someone you have not authorized wants to pick up your children. If we cannot reach you, then we will contact the other adults you have authorized on this permission form.  

Questions:  If you have any questions, email us at cbconline7202@gmail.com or call us at (316) 684-2030
NOTICE: USD 259 neither sponsors nor endorses the organization or activity represented on this form and the content or views expressed herein are solely that of the organization show. USD 259 permits the distribution of material such as this on a non-discriminatory basis regarding matters of potential interest to students and parents.
Student Information:
Student First Name: *
Student Last Name: *
Student Grade Level: *
Date of Birth (optional)
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Student Address:
Address line 1: *
Apt #:
City: *
State: *
Zip Code: *
Student Other Information:
List Allergies: Enter "None" if the student has no allergies. *
List any special needs:
List any security/custody issues with this child:
Parent/Guardian Information:
Parent/Guardian Name: *
Parent/Guardian Phone Number: *
May we text you club updates?
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Parent/Guardian Email Address:
Emergency Contact Name: *
Emergency Contact Phone: *
Emergency Contact Relationship to Child *
Authorized Persons (18 years old & older) who you authorize to pick up your child(ren):
Please Note: For the safety of the children entrusted to our care, we will contact you or your emergency contact if someone who is not authorized to pick up your child tries to pick up your child(ren). Please be prepared to show some form of photo identification when you sign out your child(ren).
Name of Authorized Person to Pick up Child *
Telephone number of Authorized Person to Pick up Child
 *
Relationship of Authorized Person to Child: *
Name of Authorized Person to Pick up Child (optional):
Telephone Number of Authorized Person to Pick up Child (optional):
Relationship to Authorized Person to Child (optional):
Name of Authorized Person to Pick up Child (optional):
Telephone Number of Authorized Person to Pick up Child (optional):
Relationship to Authorized Person to Child (optional):
Indicate how your child will get home on club day: *
Required
We would like to make sure that you know if your child forgets to stay for club and is either on the bus, walking home or at latchkey. Should we call you if your child does not show up at club? *
Required
By Checking this box below, I acknowledge that I am the Parent/Guardian of the child listed on this permission form and I give permission for this child to attend Good News Club at Celebration Baptist Church at the corner of 9th & Armour Road every Thursday after school on full days of school from February 20 to April 3, 2025 (except March 20). Good News Club workers have my permission to walk my child to Celebration and, if necessary, back to Price-Harris. I understand that my child is expected to follow USD 259 Code of Conduct rules or may be dismissed from Good News Club. I understand it is my responsibility to pick up my child at 5:30pm and failure to do so will jeopardize my child's continued participation.
*
Required
OPTIONAL: Photography and Video Release
From time to time, the Good News club may document the activities with photos or videos. As parent or guardian of this child, I hereby assign and grant to Celebration Baptist Church, Good News Club, Child Evangelism Fellowship of Kansas, its subsidiaries and successors, and assign the unqualified right to the ownership, use and proceeds of all photographs and video recordings 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 in print and online. *
If any information on this permission form changes at any time please submit a new permission form. We also ask that you complete a permission form for each child. 
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