VBS/Good News Club Registration Form

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VBS/Good News Club Registration Form

Child's Name(Required)

Birthday

Age(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

School(Required)

Grade(Required)

Parent/Guardian

Home Phone(Required)

Dad's Work Phone

Mom's Work Phone

Emergency Contact Person 1

Emergency Phone 1

Emergency Contact Person 2

Emergency Phone 2

Child’s Allergies (peanuts, chocolate, etc.)

The following persons are allowed to pick up my child in the event that I cannot.

Name 1

Phone Number 1

Name 2

Phone Number 2

Name 3

Phone Number 3

Permission

The above named child has my permission to attend the Good News Club program every week. I also give permission for the above named child's voice and image to be included in photos/videos for promotional purposes. I promise not to hold BMBC, its staff, or the host responsible for any injuries or sickness that has occurred at or as a result of this program.

Signature

Date

Download CEF Good News Club Registration Form 2024