North Hopewell-Winterstown After School In School Good News Club

Please complete and submit a registration form for each child

North Hopewell-Winterstown Registration Form

Child's Name

Child's Birthday

Child's Gender Child's Gender Male Female

Child's Grade

Child's Teacher

Child's Address

Child's Food Allergies

Primary Contact Person

Relationship to Child

Primary Contact's Phone

Primary Contact's Email

Additional Contact Person

Additional Contact's Phone

Additional Contact's Email

Name of person (other than parent) allowed to pick up my child at the church after Good News Club

Please read and agree to the Permission Statement Please read and agree to the Permission Statement Yes, I agree to the Permission Statement No, I do not agree to the Permission Statement

I certify that I am the parent/guardian of the above-named child. I certify that I am the parent/guardian of the above-named child. Yes, I am the Parent/Guardian No, I am not the Parent/Guardian

Please type your full name as your virtual signature to all of the above:

2 + 10 =

MEETS: THURSDAYS 3:30 P.M. to 4:50 P.M. AFTER SCHOOL at Pleasant View Church, 10384 Winterstown Road.
The Club will run from October 15, 2026 to March 25, 2027
Parents are responsible for transportation home from the church. CEF cannot provide transportation home.
CHILDREN MUST BE PICKED UP BY 4.55 P.M.
SPONSORED BY: Child Evangelism Fellowship of York County.
For more information contact Lisa Garlick, Director at (717) 757-3212 or lisagarlick@cefepa.net

Permission Statement

I give permission for my child to take part in the After School Good News Club Program.

I give my permission for CEF to transport my child from North Hopewell- Winterstown Elementary to Pleasant View Church for the After School/Good News Club.

I will pick up my child after club at Pleasant View Church.

I understand that there is NO club on days there is no school or on days that let out early.

In case of a medical emergency I give permission to the physician selected by the CEF of York County to secure proper treatment. In extreme emergency circumstances they may hospitalize, order medication and, if necessary, surgery. I agree that my child is in good physical condition and able to participate in the After School/Good News Club program they are registering for. I agree to hold Pleasant View Church and CEF of York County, Inc. harmless, and to secure them against all losses and expenses due to injury or alleged injury to my child in relation to their participation in this program. I also assume the responsibility of any damages to the facility and/or equipment being used caused by him or her. I grant permission for any photos taken of my child to be used for future publications.