Good News Club Registration
Note: Fields highlighted pink are required!
Club Information
Club: Piney Ridge
2025 - 2026
| Day of Week | Start Time | End Time |
|---|---|---|
| Monday | 15:30 | 17:00 |
| Team Lead(s) | Phone # | |
|---|---|---|
| Darlene Ely | 443-547-2646 | dely216@comcast.net |
| Sara Tully | 443-983-3430 | sarakmtully@gmail.com |
Please contact the team lead directly for any questions, concerns, or registration issues.
Primary Parent/Guardian
First Name
Last Name
Parent/Guardian Type
Phone #
Email
Preferred Contact Method
Address
Child Information
Addition Parent(s)/Guardian(s)
Security or Custodial Issues
No security issues
Final Details
Church Affiliation
Note - we will try to accomodate your childs needs, but we are not equipped to handle all situations.

