Good News Clubs – Tyler

Registration for Tyler Good News Club

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Good News Clubs - Tyler - Virtual

Time: Thursdays 3:00 to 4:00
Date: February 4 & ends March 18
NOTE: Club breaks in December, restarts after the New Year and ends in the spring, as notified.
Place: Online via Zoom (Zoom details given after signed registration form received)
Who can attend? All boys and girls in grades 3-5, regardless of religious background. Parents are welcome to attend with their child anytime.
Sponsored by: Bethel Baptist Church & CEF of VA
Contact for Information: Korey Kelley; kkelley@bbmva.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

I give my permission for my above-named child to attend the Good News Club during the 2020-2021 school months. *

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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