Mint Valley Good News Club Registration

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Good News Club is an exciting, fun-filled 1 1/2 hour after-school club held once a week.

It includes:

-Dynamic Bible Lessons
-Creative Learning Activities
-Inspiring Missionary Stories
-Meaningful Songs
-Life-changing Scripture Memory

Your child will learn:

-Respect for Authority
-Character Qualities
-Moral Values
-Biblical Principles

Who teaches the club: Specially trained Christians concerned for the spiritual well-being of your child teach the club. All club workers are screened as required by CEF's child protection policy to ensure your child’s safety.

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Sponsored by: Child Evangelism Fellowship

Hosted and Conducted by: Jocelyn Schauer: 360-562-1957

Time: After School 3:30 - 5:00 pm.

Dates: Every Monday Fall: 10/7, 10/14, 10/21, 10/28, 11/4, 11/18, 12/9 Winter: 01/27, 2/3, 2/10, 2/24, 3/3, 3/10, 3/24

Who can attend: All boys and girls grades K - 5, regardless of religious background. Parents are welcome to attend with child.

friendly tip:

SCREENSHOT this page to keep track of the dates! :)

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Parent /Guardian: Your child must be picked up immediately after the club ends. Our policies do not allow Good News Club teachers or helpers to remain at school after club. If your child is not picked up immediately after club three times throughout the school year, he/she will not be allowed to continue attending the club. Thank you.

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 is not an activity of the school or the Longview School District.

Please fill out the bottom portion of this application and submit!

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Enter Your Child's Name Below:* This field is required.

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I understand Mint Valley GNC will meet after school on these dates: Fall Club: Oct 6, 13, 20, 27, Nov 3, 10 Dec 8 Winter Club: Jan 26 Feb 2, 9, 23 Mar 2, 9, 23* This field is required.

Yes

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I realize that if I have questions or there is a club day emergency, I can contact Jocelyn Schauer: 360-562-1957* This field is required.

Yes

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I understand that it is my responsibility to pick up my child at 5:00 p.m. and failure to do so will jeopardize my child's continued participation.* This field is required.Parent/Guardian Signature

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Date:* This field is required.

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Check here to show how your child will get home on club day.* This field is required.

My child will be picked up in car line.

My child will walk home.

My child goes to the school's extended day/after-school program.

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Is either parent in the military?

Yes

No

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Photo/Video Release Agreement: I grant Lower Columbia CEF & WA State CEF the right to use photographs of my child on the website or newsletter to promote Child Evangelism Fellowship.* This field is required.

Yes

No

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Parent/Guardian Initials

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Child's First Name* This field is required.

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Child's Last Name* This field is required.

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Birthdate:* This field is required.

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Age:* This field is required.

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Gender:* This field is required.

M

F

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Homeroom Teacher* This field is required.

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Grade* This field is required.

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Address* This field is required.

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Apt

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City* This field is required.

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Parent First Name* This field is required.

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Parent Last Name* This field is required.

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Email* This field is required.

example@example.com

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Home Phone* This field is required.

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Dad’s Cell/Work Phone

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Mom’s Cell/Work Phone

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Emergency Contact Person 1* This field is required.

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Phone* This field is required.

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Emergency Contact Person 2

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Phone

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Child’s Allergies

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Child’s Special Needs

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Church

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Pastor

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This person is allowed to pick up my child if I'm not able:* This field is required.

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Phone Number* This field is required.

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This person is allowed to pick up my child if I'm not able:* This field is required.

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Phone Number

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This person is allowed to pick up my child if I'm not able:

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Phone Number