Good News Club Registration

Note: Fields highlighted pink are required!

Club Information

Club: Manchester
2025 - 2026
Day of WeekStart TimeEnd Time
Wednesday16:1517:15
Team Lead(s)Phone #Email
Pastor Gary Pastor Gary Mills717-965-5695skmills45@hotmail.com
Sandra Mills717-965-5688skmills45@hotmail.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.

Signature