2022-2023 Good News Club Student Registration Form First Baptist Church of Springfield / Ebenezer Elementary

TUESDAYS AFTER SCHOOL UNTIL 5:00PM on Full Days of School | Thank you for registering your child in the Good News Club at EBENEZER ELEMENTARY!

Please complete this form in it's entirety and submit. Complete one form per child. You will receive a confirmation, as well as a confirmation email with all the details about this Good News Club including start date and contact information.

School Name = Ebenezer Elementary School
Church Name = Springfield First Baptist
Coordinator Name = Rebecca Young
Time of Club= after school until 5pm
Date club will start & end. = 10/11/22 - April 2023
Day of week club will meet = Tuesdays
Where (what room you will meet in) = Music Room
What grades can attend. = 4th and 5th
Who can attend? All boys and girls, grades 4th-5th, regardless of religious background. Parents are also welcome to attend with child, however interaction with other children is not allowed without a background check on file with CEF.
Acknowledgements

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By typing your name below, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this form. You are agreeing that you have read and understand the statements listed above.
 
Child's Information

 
 
 
 
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IF YOU ANSWER NO TO ANY OF THE QUESTIONS BELOW PLEASE PUT N/A IN 'EXPLAIN' SECTION.  THANK YOU.
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Contact Information

Please enter the BEST mobile number to reach someone. Please note we may also send reminders/announcements via text message.
 
Please enter the BEST email address for correspondence with your child's Good News Club.  Please note we may also send reminders/announcements via e-mail.
 
 
 
 
 
 
 
 
 
 
 
Permission for Pick Up

Below is a list of names allowed to pick my child up from Good News Club **Please include your name as a pick up person** Your child will only be allowed to ride home with the names you list below.  We will check photo ID's to verify identity.  Please note any changes you make with the school office regarding pick up of your child are not shared with us.  You will also need to contact us with any needed changes in the future.
 
 
 
 
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Additional Information

 
OPTIONAL Photography and Video Release

Child Evangelism Fellowship® may, from time to time, document the activities of the ministry with photos or videos. I hereby assign and grant to Child Evangelism Fellowship Inc., its subsidiaries and successors, and assign the unqualified right to the ownership, use and proceeds of all photographs or video of me or my minor child, without reservation or limitation, including use of photographs or video of me or my minor child for, but not limited to, advertising, educational and promotional purposes.
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COVID Information

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. As a result, federal, state, and local governments and agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. We are doing everything we can to be compliant with all regulations and ensure your safety. We have put in place preventative measures to reduce the spread of COVID-19, but we cannot guarantee that you or family members will not become infected with COVID-19.


By participating in programs, services, and activities of Child Evangelism Fellowship of Georgia you agree to the following:




On behalf yourself and your children, you hereby release, covenant not to sue, discharge, and hold harmless Child Evangelism Fellowship of Georgia, its employees, agents, and representatives, of and from all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating to your participation in our programs, services or activities. You understand and agree that this release includes any claims based on the actions, omissions, or negligence of this organization, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any such program, service or activity.

By typing your name below, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this form. You are agreeing that you have read and understand the statements listed above.

 

Description

TUESDAYS AFTER SCHOOL UNTIL 5:00PM on Full Days of School
Thank you for registering your child in the Good News Club at EBENEZER ELEMENTARY!

Please complete this form in it's entirety and submit. Complete one form per child. You will receive a confirmation, as well as a confirmation email with all the details about this Good News Club including start date and contact information.

School Name = Ebenezer Elementary School
Church Name = Springfield First Baptist
Coordinator Name = Rebecca Young
Time of Club= after school until 5pm
Date club will start & end. = 10/11/22 - April 2023
Day of week club will meet = Tuesdays
Where (what room you will meet in) = Music Room
What grades can attend. = 4th and 5th