5-Day Club Host Registration Form

5-Day Club Host Registration Form

Choice of club date/time preference is first come first serve basis. Thank you for your willingness to serve your community this summer!
Please select your preferred week/time that you'd like our CYIA Team to teach. The actual teaching is 1.5 hours. **Please note that we do not have time slots for afternoon due to the weather factors.***
For any host that plans to host in a community park, we recommend you start your program after 11:00AM or in early afternoon time slots like 4:00PM.
If you need a different start-end time for the CYIA Team's 1.5 hours 5-Day Club time, please specify below or type "N/A".*

Part I. Host Information
Host Organization/Private Host Name*
For private hosts, feel free to create a fun name.
Host Contact*

First NameLast Name
Host Mobile Phone #*
Please enter a valid mobile phone number; not the church's office phone number.
Host Email*
example@example.com
Co-Host Full Name*

First NameLast Name
Co-Host Mobile Phone
Please enter a valid mobile phone number; cannot be the church office phone number.
Co-Host Email*
example@example.com

Part II. 5-Day Club Information
What is your 5-Day Club name to be used on flyers & listed on the website? For example, if your club takes place at a community park, instead of your church name, you could use the park name instead.*
5-Day Club Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email to receive registration notifications*
example@example.com
Phone number on flyer for inquiries (be sure someone is available to answer even after hours)*
Please enter a valid phone number.
Please provide the parking, drop-off & pick-up instructions, classroom # if applicable. (A large/open space where our staff can facility games and activities in a safe setting.)*

Part III. Acknowledgement & Worker's Compliance Agreement Signature
ACKNOWLEDGEMENT OF HOST RESPONSIBILITIES: As a host, I understand that I cannot cancel hosting a club after I signed up. Prepare & distribute 5DC invitation flyers with your name and phone number on the invitation in case parents have questions. Within 24-48 hours a registration form is received, you are to send a welcome message to parents with detailed club date/time/location/parking/drop-off/pick-up instructions. [Staffing Requirement: at least 1 volunteer helper for a private host, 2-3 volunteer helpers if you expect 10+ kids, 3-5 helpers for 20+ kids. The ratio should be 1 helper every 3-5 kids.] Send reminder email/text to your confirmed guests the week before club begins. On the day of club, you or your team of helpers will greet your guests and/or participants. Be sure to provide treats and raffle draw prizes for the CYIA Team to use as incentives every day of the club week. On the last day of club, it is the responsibility of the Hosts to provide goodies, treats &/or gift cards as incentives. In some situations, it is good to remind your guests and/or participants to remove anything that might create any distractions during the club. The CYIA teachers will communicate any disciplinary concerns to you. But as the host, you are recommended to handle them directly with care and grace. Host briefing meeting attendance is mandatory.*

I fully understand my responsibilities as a 5-Day Club® Host.
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 and my minor child for, but not limited to, advertising, educational and promotional purposes.Authorization for Photography and Video Release.*

Yes, I agree.

Part IV. Questions & Referrals
Please specify who will be the supervisor for your 5-Day Club (include email & phone #). Our Summer Ministry Coordinator will respond upon submission. *
If you would like to refer a potential host for the 5-Day Club®, please list their names and contact information (email, phone #, affiliated church name). A brief description would be greatly appreciated.
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