MARVIN ELEMENTARY SCHOOL
Good News Club Registration
Tuesdays, 2:00-3:30 pm
February 10 - March 31, 2026
Child Information
Child's Full Name
*
Child's Grade
*
Home Room Teacher Name
*
Child's Gender
*
Please Select
Male
Female
Birthday
-
Month
-
Day
Year
Date
Allergies
*
Please list known allergies. If none, type NA
Mode of Dismissal from Good News Club?
*
Please state how this student will return home after club (car line, walk home, etc.)
List any security/custody issues with this child
List any special needs
ADD, ADHD, Asperger's, Dyslexia etc.
Anything else you would like to share about your child?
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PARENT / GUARDIAN INFORMATION
Parent/Guardian Full Name
*
Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Home Address
*
Please enter full address.
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Name
*
Full Name
Emergency Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Alternate Pick Up 1 (This person is permitted to pick up my child)
Full Name
Contact Number
Alternate Pick Up 2 (This person is permitted to pick up my child)
Full Name
Contact Number
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PERMISSION TO ATTEND GOOD NEWS CLUB
My children, listed on this form, have permission to attend the Good News Club after school club.
*
YES
NO
Photography and 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.
YES
NO
Signature
*
Date
-
Month
-
Day
Year
Date
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