Good News Club Registration

Note: Fields highlighted pink are required!

Club Information

Name: Ebb Valley
Day of Week Start Time End Time
Tuesday 4:10 pm 5:30 pm
Team Lead(s) Phone # Email
Laurel Nalepa (443) 293-2595 Laurelnalepa@gmail.com
Please contact the team lead directly for any questions or concerns regarding the club and times.
If you encounter any errors during the registration process, please immediately contact the CEF Admin [(443) 791-0031]!

Child Information

Parent/Guardian #1

First Name
Last Name
Phone #
Email
Address

Parent/Guardian #2

First Name
Last Name
Phone #
Email
Address

Additional Contacts - Pickup or Emergency

Final Details

Church Affiliation
Note - we will try to accomodate your childs needs, but we are not equipped to handle all situations.

Signature