Good News Club Registration Good News Club Registration Child’s First Name * Child’s Last Name * Preferred Name If different then above Gender * Boy Girl Age * Birthdate * Month/Day/Year; 01-23-2010 Grade * K 1st 2nd 3rd 4th 5th 6th 7th Other School * Good News Club you are registering for: Alsea Elementary GNC Clemens Primary GNC Franklin After-School GNC Monroe Grade School GNC Mountain View Elementary GNC Philomath Elementary GNC Online GNC, Tuesdays@1:30pm Online GNC, Thursdays@1:30pm Mailing Address * City * Zipcode * Primary Phone Number * Secondary Phone Number * Church Primary Email * How did you hear about Good News Club? * Received invite in the mail Has attended before Friend Church CEF Ministry (5-Day Club, Camp Good News, etc.) Other Child’s Allergies or Food Restrictions gluten, dairy, nuts, etc. T-Shirt Size * Youth S Youth M Youth L Youth XL Note Is there anything else we should know about your child Guardian #1 Name * Relation to Child * Primary contact best reached by: * Email Text Call Adults allowed to pick up child * Please list up to 5 adults who are allowed to pick up your child Parent or Guardian Signature * “I, the parent (or guardian) of the above named student, do hereby give my permission for my child to attend Good News Club. I understand that they are expected to attend Good News Club each week, unless sick or a note was turned in to the school office. I understand there may be occasions when my child may travel in a vehicle from location to location in the company of only one adult of legal age and give permission for him/her to do so. If attending an online club, I understand that I am giving my permission for my child to attend by providing them the link to the livestream site.”” Date * Parent Signature – Photography Release (Optional) “I grant to CEF full use of all photographs and videos taken of the above named child during Good News Club, without reservation or limitation. I understand that the images may be used in print publications, online publications, websites, and social media, such as: newsletters, brochures, Facebook™ and Instagram™.” Submit If you are human, leave this field blank.