Good News Club Permission Slip

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Lake Forest/Jackson in Home - Tuesdays - 3:20 pm

Email *

Thank you for your interest in our online Good News Club. All children are welcome with their parent’s permission. Parents are also welcome. This registration is for the Good News Club hosted by CEF NorCal Greater Sacramento Area.

If you have more than 3 children, please complete and submit this form then fill out again with additional child(ren)'s info!

Child #1 Name (first and last) *

Grade *

Child #2 Name (first and last)

Grade

Child #3 Name (first and last)

Grade

School Name *

Street Address *

City *

State *

Zip *

Any security/custody issues?

Any special needs?

Allergies?

Family Email (if different than above)

Home Phone

Parent #1 Work/Cell Phone *

Parent #2 Work/Cell Phone

Do you attend church? If so, where?

Emergency Contact #1

Emergency Contact #1 Phone Number

Emergency Contact #2

Emergency Contact #2 Phone Number

***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 time. Our policies do not allow GNC workers 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.

Indicate how your child will get home on club day

My child will be picked up after Good News Club

My child will walk home after Good News Club

My child is registered for and will attend an extended day/after-school program

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PERMISSION FOR PICK UP—in addition to those listed above, the following people are allowed to pick up my child:

PARENT/GUARDIAN SIGNATURE REQUIRED: My children, listed on this form, have permission to attend the CEF Good News Club. I understand it is my responsibility to pick up my child and failure to do so will jeopardize my child’s continued participation.(NOTE: On electronic forms, your typed signature has the same effect as your written signature.) *

OPTIONAL Photography and Video Release (Not required for club attendance)

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. (NOTE: On electronic forms, your typed signature has the same effect as your written signature.) (PARENT/GUARDIAN: type name below to sign)

When we receive your completed registration form we will send information on how to access the online Good News Club. For your child’s safety, only children with permission from parents may attend. Teachers in our clubs have been screened according to the Child Protection Policy of Child Evangelism Fellowship.

Please contact carl.geil@cefnorcal.org if you have any questions!

A copy of your responses will be emailed to the address you provided.

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