Word of Faith Church: Good News Club Registration Form (2019/2020)
Sponsored by:  Child Evangelism Fellowship NorCal East Bay
Hosted and Conducted by:  Word of Faith Church; 510-234-4388
Start Time: 5:00 PM  
End Time: 6:15 PM
Date:  Every Wednesday starting December 4, 2019. Club will run until May 13, 2020. Your child can join at any time.
Place: Word of Faith Church (2100 Broadway Avenue, San Pablo, 94806)
Who can attend?  All boys and girls, grades K-6th, regardless of religious background.
Parents are welcome to attend with child.
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My child (name below) is allowed to attend the Good News Club every Wednesday from 5:00 pm until 6:15 pm at Word of Faith Church. Club will run until May 13, 2020. I understand it is my responsibility to pick up my child at 6:15 pm. Alternatively, my child can attend Church Service (7pm to 9pm) including Youth Choir practice when it happens. *
Parent / Guardian Signature AND Date *
***I agree that my printed name and date are my signature on this registration form***
Check here to show how your child will get home on club day *
Pick up transportation is needed (local area only)
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CHILD'S INFORMATION
2019/2020 School Year
Grade *
Name *
Gender *
Birth Date *
Age *
Address *
(Please include Street Number, Street Name, Apartment Number, City, State, and Zip Code)
Parent/Guardian Name *
E-mail
Home Phone *
Dad's Work / Cell Phone *
Mom's Work / Cell Phone *
Emergency Contact Person *
Emergency Contact Person's Phone *
Preferred contact method *
Required
Child's Allergies *
(Peanuts, chocolate, etc.)
Church
These People (include phone numbers) are allowed to pick up my child if I'm not able:
Please include a maximum of 3 people
Submit
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