Good News Club® Registration

Thank you for your interest in Good News Club. Children K5-5th grade are welcome to attend with their parent’s permission.

You are registering your child to participate in the Good News Club at Clear Spring Elementary School.

***I give my permission for my child to be transported by bus from Clear Spring Elementary to Hilltop Christian Fellowship and agree to pick my child up there at 4:00 PM.****

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. Thank you for understanding.

The United States Constitution requires schools to respect the right of all external organizations to distribute flyers to students at school if the school permits any such organization to distribute flyers. Accordingly, the school cannot discriminate among groups wishing to distribute flyers at school and does not endorse the content of any flyer distributed at school. The school encourages parents to assist their children in making choices appropriate for them.

“This program, activity, product, or service is not sponsored by or affiliated with Washington County Public Schools.”

Email*

example@example.com

Child's Name*

First NameLast Name

Gender*

MaleFemale

Age

Birth Date*

MonthDayYear

Grade*

Homeroom Teacher*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Language(s) spoken

Security/custody issues? (If yes, please explain.)*

Special Needs *

List any special needs (ADD, Asperger’s, Dyslexia, learning or behavioral challenges etc.) that might help us to serve your child better!

Child's allergies (peanuts, chocolate, etc.)*

Parent/Guardian Information

Parent 1 Name*

First NameLast Name

Parent 1 Phone*

Parent 2 Name

First NameLast Name

Parent 2 Phone

Church

Is either parent in the military?*

YesNo

Signature

Emergency Information

Emergency Contact 1 Name*

First NameLast Name

Emergency Contact 1 Phone Number*

Emergency Contact 2 Name*

First NameLast Name

Emergency Contact 2 Phone Number*

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 after-care program

Who should be called first regarding pick up?

In addition to those listed above, the following people are allowed to pick up my child. Please include name(s) and phone number(s)

My child is allowed to attend the Good News Club at Clear Spring Elementary School on Wednesday afternoons when there has been a full day of school. Club will begin October 8, 2025. I understand it is my responsibility to pick up my child at 4:00 PM and failure to do so will jeopardize my child’s continued participation.

Parental Acknowledgement and Approval*

YesNo

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.

OPTIONAL Photography and Video Release

YesNo

FYI

Questions? Please feel free to contact John & Melissa Miller by email: john@hilltopcf.com.

Good News Club is a ministry of Child Evangelism Fellowship®. All CEF workers are screened as required by CEF’s Child Protection Policy.