GNC Online Registration Form Feb 2021

Online Good News Club® Registration

Complete the registration form below to sign your child up for the February 5, 2021 - March 19, 2021 Online GNC™.
This is not an activity of the school or the school district.
Child's Name *

First Name Last Name
Child's Birth Date: *

Month Day Year
Address:

Street Address

Street Address Line 2

City State

Zip Code
Child's School Name *
School Name
Child's Teacher's Name *

Prefix First Name Last Name
Child's Grade *
Grade
Mother's/Guardian's Name *

First Name Last Name
Mother's/Guardian's Cell Phone Number: *

Area Code Phone Number
Mother's/Guardian's E-mail *
example@example.com
Father's/Guardian's Name *

First Name Last Name
Father's/Guardian's Cell Phone Number: *

Area Code Phone Number
Father's/Guardian's E-mail *
example@example.com
Family's Church *
Church
Is a parent in the military? *
Military Parent
Does the child have any special needs (ADD, Asperger’s, Dyslexia, etc.) *
If you answered "YES" to the question above, please list the special needs of the child. (ADD, Asperger’s, Dyslexia, etc.)
Special Needs
Emergency Contact #1 *

First Name Last Name
Phone Number *

Area Code Phone Number
Emergency Contact #2 *

First Name Last Name
Phone Number *

Area Code Phone Number
My is allowed to attend CEF® Online Good News Club® conducted by Child Evangelism Fellowship®, each Friday beginning Friday, February 5, 2021 until the last day being on Friday, March 19, 2021. When we receive this completed registration form we will email you 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 Policy of Child Evangelism Fellowship®. *

I hereby grant permission for my child to attend CEF® Online Good News Club®.
Name *

First Name Last Name
Signature

Clear
OPTIONAL Photography & Video Release Form

Photography & 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.

I hereby grant permission to take photos and/or videos of my child during CEF's Online Good News Club®. I do NOT grant permission to take photos and/or videos of my child during CEF's Online Good News Club®.
Name *

First Name Last Name
Signature

Clear
How did you hear about CEF's Online Good News Club®?
Should be Empty:

Online Good News Club® Registration

OPTIONAL Photography & Video Release Form