Harrisburg Virtual Online GNC Registration Form

Thank you for your interest in our online Good News Club. All children are welcome with their parent’s permission. Parents are also welcome.

Please complete the following information to register your child(ren) for the Good News Club.

This Registration is for the Good News Club being hosted by: Greater Life Baptist Church

Good News Club Dates: Tuesday, Starting October 27, 2020

Good News Club Times: 3:00-4:15 p.m.

List children's names & grades.

First Name Last Name

First Name Last Name blank

Family email address: Email Family phone number Phone Number

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

School

County

Due to the nature of online video conferencing platforms, you, as the parent/guardian, understand that your child will participate in a live feed video during the Good News Club. Your child must abide by the rules of the online Club or may be disconnected until the next Club meets. Continual disruption may exclude your child from further entry into the Club time.

My children, listed on this form, have permission to attend the CEF online Good News Club.

Parent/Guardian Signature:

Clear

Date

(NOTE: On electronic forms, your typed signature has the same effect as your written signature.)

When we receive your completed permission 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. Also, teachers in our clubs have been screened according to the Child Protection Plicy of Child Evangelism Fellowship.

Children may invite friends by having them register at: www.cefcrc.org (under the school they attend). Chester, Lancaster, York counties only.

Please feel free to contact us if you have any questions.

Kristen Cairnes 704-541-6226 email: greaterlifekids@aol.com

My child, listed on this form, has my permission to attend the GOOD NEWS CLUB® at Greater LIfe Baptist Church (There will be no clubs on half days and school holidays.) Our policies do not allow GNC workers to remain after club. I understand it is my responsibility to pick up my child immediately at the end of club at 4:30 p.m. and failure to do so will jeopardize my child’s continued participation. I also understand volunteers who are leading the club are not medically trained. Child Evangelism Fellowship® of South Carolina (CEF-SC) encourages participating church volunteers to follow the school’s COVID-19 safety guidelines in providing a safe atmosphere for your child’s participation. Please note that your child’s participation carries the same potential illness risks as going to other public spaces such as grocery stores, gas stations or church. Further, as the Corona-virus is an infectious disease, you also acknowledge the potential risk of spreading the virus to your own household, neighborhood, and other contacts through your child’s participation. Therefore, by signing below in agreement for your child to participate, you and your household acknowledge the potential risks associated with your child’s participation and waive all responsibility and liability from CEF-SC and participating churches, regardless of care or negligence and endangerment along with any and all harm, including but not limited to harm relating to COVID-19. This undersigned releases any and all liabilities from CEF-SC corporately, as well as all staff, or anyone, paid or volunteer, who is associated with the ministry of CEF-SC in any capacity, for any reason, including but not limited to churches and other third parites that host CEF events.

Parent/Guardian Signature:

Clear

Parent/Guardian Printed Name:

Date

(NOTE: On electronic forms, your typed signature has the same effect as your written signature.)

How will your child get home on club day:

If being picked up, please provide Dismissal or Car Tag Number to Coordinator

CHILD INFORMATION

First Name Last Name

Preferred Name Age Birthdate Teacher

Food Allergies Learning Needs Medical Needs Church Child Attends Pastor

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Email

Families primary email address - Your email address will NOT be used for non-club purposes! Please include so we may send important GNC reminders.

Phone Number

Area Code Phone Number

SIBLINGS ATTENDING

First Name Last Name

CONTACT INFORMATION - Please include 4 contacts for your child(ren) and indicate if Emergency, Pick-up, or Both

First Name Last Name Phone Number

Virtual Online Good News Club Registration Form