Good News Club Registration

Note: Fields highlighted pink are required!

Club Information

Club: Piney Ridge
2026 - 2027
Day of WeekStart TimeEnd Time
Monday 3:30 pm 5:00 pm
Team Lead(s)Phone #Email
Darlene Ely443-547-2646dely216@comcast.net
Sara Tully443-983-3430sarakmtully@gmail.com
Please contact the team lead directly for any questions, concerns, or registration issues.

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