Good News Club Registration Form

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GNC Registration - 2025/2026

Student Name and age 1 *

Student Name and age 2

Student Name and age 3

Parent First Name *

Parent Last Name *

Parent Email *

Parent Phone 1 *

Student Residence *

City *

State/Province *

Zip/Postal Code *

Country

Name of your Elementary School

Student Birthday *

What Chapter is your school in? *

Central New Mexico Chapter

Northern New Mexico Chapter

Southern New Mexico Chapter

No Chapter - CYIA Staff

List heath or other conditions that would limit the child’s participation in CEF® activities *

I hereby assign and grant to CEF 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 the use of photographs or video of me or my minor child for, but not limited to, advertising, educational, and promotional purposes.

Please list the allergies or Diagnoses below

Section

Emergency Contact 1 Name *

Emergency Contact 1 Phone Number *

Emergency Contact 2 Name *

Emergency Contact 2 Phone Number *

List Name and Phone Number of ALTERNATIVE PICK UP *

Who is NOT ALLOWED TO PICK UP YOUR CHILD

Emergency Release - Print Below

I hereby release Child Evangelism Fellowship® Inc., its staff, board members, & agents from responsibility & liability for any injury or illness that my child may sustain during the above-mentioned CEF® program. I hereby permit for my child to receive med

Electronic Signature *

Data Privacy & Consent

Yes, I would like to receive communications from CEF of New Mexico (GNC) by email.

Yes, I would like to receive text messages from Child Evangelism Fellowship Of NM (Good News Club)

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