VBS - 2022 - Kids Registration (Ages 3 - 14)
Here are the VBS Details:

The VBS program is for kids ages 3 through 14.
If you have multiple kids, please fill the form for every kid.

Address: 460 South Cypress Ave, San Jose, CA
Phone: (408) 247-5673
Dates and Time: June 3’ (6PM–9PM), June 4’ (9AM–5PM), & June 5’ (9AM-5PM)
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Child's Name: *
Grade: *
Dates Attending: *
Required
Parent Name: *
Primary Phone Number: *
Email Address: *
Emergency Contact Name: *
Emergency Contact Number: *
Allergies: (If no allergies put 'None') *
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