Bellwood Boys & Girls Club Good News Club ® 2:45-4:15pm - Student Registration Form
Good News Club is an exciting, fun-filled weekly club for kids including dynamic Bible lessons, creative learning activities, inspiring missionary stories, meaningful and fun songs, and life-changing Scripture memory. Your child will learn respect for authority, moral values, character qualities, and Biblical principles.

The club will meet from XXXXXXXX to XXXXXXXX on XXXXXXXXXXX afternoons.

Please use this form to register your child for the Good News Club after-school program.
Parents are also welcome to attend with child, however, interaction with other children is not allowed without a background check on file with CEF.
Email address *
Parent/Guardian
CEF does not provide transportation to the Good News Club location. Parents must arrange transportation to the GNC location and must pick up each child promptly at GNC end of time. Our policies do not allow GNC teachers or helpers to remain after club. If your child is not picked up immediately after club three times throughout the school year, he/she will not be allowed to continue attending. Thank you for understanding.
Child's name *
First and last name
Your answer
Child's Grade *
Child's Homeroom Teacher *
Your answer
Child's Gender *
Child's Birthdate *
MM
/
DD
/
YYYY
Home Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Family Email *
Your answer
Home Phone *
Your answer
List any security/custody issues with this child
Your answer
Dad's First and Last Name *
Your answer
Dad's Phone *
Your answer
Mom's First and Last Name *
Your answer
Mom's Phone *
Your answer
List any special needs your student may have (ADD, Asperger's, Dyslexia, etc.)
Your answer
List any child allergies your student may have (peanuts, chocolate, etc.)
Your answer
Emergency Contact #1 First & Last name *
Your answer
Emergency Contact #1's phone number *
Your answer
Emergency Contact #2 First & Last name *
Your answer
Emergency Contact #2's phone number *
Your answer
Indicate how your child will get home on club day (Choose One): *
Required
Additional authorized pickup #1. In addition to emergency contacts, the following person (full name) is allowed to pick up my child:
Your answer
Additional authorized pickup #1 cell phone:
Your answer
Additional authorized pickup #2. In addition to emergency contacts, the following person (full name) is allowed to pick up my child:
Your answer
Additional authorized pickup #2 cell phone:
Your answer
Church
Your answer
This is not an activity of the school or school district.
United States Constitution requires schools to respect the right of all external organizations to distribute fliers to students at school if the school permits any such organization to distribute fliers. Accordingly, the school cannot discriminate among groups wishing to distribute fliers at school and does not endorse the content of any flyer distributed at school. The school encourages parents to assist their children in making choices appropriate for them.
Parent/Guardian Signature. By typing your name and clicking the "submit" button, you've electronically signed the record, according to the Uniform Electronic Transactions Act (UETA). *
Your answer
Official Photography and Video Release
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.
Parent/Guardian Signature for Official Photography and Video Release. By typing your name and clicking the "submit" button, you've electronically signed the record, according to the Uniform Electronic Transactions Act (UETA).
Your answer
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