Child Registration Name of School / Club Location Select School Brown, Hannah Marie Elementary Thursdays @ 3:30 – 5:00 Starting Sept 17th Bunker, Berkeley L. Elementary Tuesdays @ 1:45 – 3:00 Starting Sept 8th Christensen, M.J. Elementary Thursdays @1:45 – 3:00 Starting Sept 17th Sewell, C.T. Elementary Mondays @3:30 – 4:45 Starting Oct 5th Deskin, Ruthe Elementary Fridays @3:30 – 4:45 Starting Sept 11th Detwiler, Ollie Elementary Mondays @1:45 – 3:15 Starting Sept 14th Fong, Wing & Lilly Elementary Wednesdays @3:50 – 5:05 Starting Sept 9th Galloway, Faye Elementary Wednesdays @3:30 – 4:45 Starting Sept 9th Goolsby, Judy & John L. Elementary Wednesday @3:30 – 4:45 Starting Sept 16th Hayes, Keith & Karen Elementary Wednesday @3:30 – 5:00 Starting Sept 9th Jacobson, Walter Elementary Tuesdays @1:45 – 3:15 Starting Sept 8th Scott, Jesse Elementary Fridays @1:45 – 3:00 Starting Sept 11th Katz, Edythe & Lloyd Elementary Tuesdays @2:45 – 4:00 Starting Sept 8th King, Martha P. Elementary Tuesdays @3:30 – 4:45 Starting Sept 8th Mack, Nate Elementary Wednesdays @3:30 – 5:00 Starting Sept 9th McDoniel, Estes Elementary Wednesdays @1:45 – 3:30 Starting Sept 16th McWilliams, J. T. Elementary Thursdays @3:45 – 4:45 Starting Sept 10th Pinecrest Academy Cadence Wednesdays @3:00 – 4:30 Starting Sept 16th O’Roarke, Thomas J. Elementary Thursdays @3:30 – 5:00 Starting Sept 24 Reed, Doris M. Elementary Mondays @3:45 – 5:15 Starting Sept 14th Ronnow, C.C. Elementary Thursdays @3:30 – 5:00 Starting Sept 10th Tarr, Sheila Academy of International Studies Thursdays @3:45 – 5:15 Starting Sept 10th Taylor, Glen C. Elementary Thursdays @3:30 – 5:15 Starting Sept 17th Taylor, Robert L. Elementary Tuesdays @3:30 – 4:45 Starting Sept 8th Treem, Harriet A. Elementary Fridays @3:30 – 5:00 Starting Sept 25th Twitchell, Neil C. Elementary Thursdays @2:45 – 4:15 Starting Sept 17th Vegas Verdes Elementary Wednesdays @3:30 – 4:45 Starting Sept 9th Williams, Wendell P. Elementary Fridays @3:45 – 5:15 Starting Sept 18th Child First Name Child Last Name Grade of Child Gender Male Female Child 2 First Name Child 2 Last Name Grade of Child 2 Gender Male Female Child 3 First Name Child 3 Last Name Grade of Child 3 Gender Male Female Child 4 First Name Child 4 Last Name Grade of Child 4 Gender Male Female Any food allergies or medical conditions? Please type n/a or provide appropriate details. Parent / Guardian First Name Parent / Guardian Last Name Parent / Guardian 2 First Name Parent / Guardian 2 Last Name Primary Phone Number Secondary Phone Number Email Home Address City State Country Zip Code My children, listed on this form, have permission to attend the CEF Good News Club. Yes Parent / Guardian Signature Date Emergency Contact 1 First Name Emergency Contact 1 Last Name Emergency Contact 1 Phone Number Emergency Contact 2 First Name Emergency Contact 2 Last Name Emergency Contact 2 Phone Number My child will be (please select one): Picked up by parent/ guardian Walking home Going to Safekey Going to teams Other NOTE: If your child is not picked up within 15 minutes of dismissal and we are unable to reach you or your emergency contacts, we will take your child(ren) to SafeKey. This requires that you pre-register your child(ren) for SafeKey. Please see the school office for registration forms. Your child's safety is our #1 concern. Questions? Call Marianne, Office Manager, at (702) 396-8363. Good News Club is a ministry of Child Evangelism Fellowship. I agree OPTIONAL: Photography and Video Release (Not required for club attendance) I agree Not at this time Photography Release Signature Register
