Good News Clubs – D.J. Montague

Registration for D.J. Montague Good News Club

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Good News Clubs - D.J. Montague

Time: 8:30am to 9:20am
Date: Tuesdays starting January 30^th-April 16^th
Place: D.J. Montague Elementary School- Media Center
Who can attend? All boys and girls in grades K-5, regardless of religious background. Parents are also welcome to attend with their child anytime.
Sponsored by: James River Baptist Church & CEF VA Peninsula
Contact for Information: Lem Crawford; goodnewsclub@jamesriverbaptist.org

Child Name *

Birthday - (e.g.; 10/23/2018) *

Age *

Gender *

Male

Female

Grade Level (K, 1, 2, 3, 4, 5) *

Homeroom Teacher *

Child Allergies *

Yes

No

If yes, please list allergies (peanuts, chocolate, etc.)

Is parent in military? *

Yes

No

Does your child attend church?

Yes

No

Name of church attending

Parent/Guardian Name #1 *

Parent/Guardian Phone #1 *

Parent/Guardian Email #1 *

Parent/Guardian Name #2 *

Parent/Guardian Phone #2 *

Parent/Guardian Email #2 *

Address *

Address

Address

Address

City

City

State/Province

State/Province

Zip/Postal

Zip/Postal

These people (include phone numbers) are allowed to pick up my child if I’m not able to:

Name *

Phone Number *

Name

Phone Number

I give my permission for my above-named child to attend the Good News Club during the 2023-24 school months. *

Yes

I understand my child will dismiss directly to their class when the club ends. *

Yes

I will send a note to the school requesting my child arrive early to attend the Good News Club. *

Yes

I give permission for photographs/videos of my child to be used in club and ministry promotions.

Yes

Parent/Guardian Signature: Enter your signature in the box using your finger on the touch-pad/track-pad or with your mouse's cursor in the box. *

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Date

Reference Number

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