Building Blocks Preschool After School Sports Camp Registration
Please fill in all the information below for your child. If you have more than one child attending, please fill in one form for each child. Before beginning, please read the Parent Guardian Permission/Release form on our website. You will be asked to check a box below stating that you have read this.

**NOTE: We will receive your electronic registration immediately after you press the submit button***

Please send payment check to:

Valley Sports Camp * 2360 Gunar Dr. * San Jose * CA * 95124

Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Teacher *
Your answer
Age ('17-'18) *
School your child currently attends *
If other, please list what school they attend. Thank you.
Gender *
Enrollment Option *
Please check the camp option you would like your child to attend.
Required
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Email Address *
Camp confirmations, reminders, notices, etc. will be sent to this email address
Your answer
Cell / Work / or Home Phone Number *
This should be the phone number that is best to get a hold of you during the day
Your answer
Pick Up Arrangements *
Who will pick your child up from camp, or will they attend an after school daycare?
Your answer
Describe any social, emotional, or physical needs your child may have. Please include allergies or medical concerns. (optional)
Your answer
Emergency Contact Person *
Your answer
Emergency Contact Phone Number *
Your answer
How did you hear about the camp? *
Check all that apply.
Required
Parent Guardian Permission/Release *
Please see the Parent Guardian Permission/Release page on our website
Required
Please press submit, and your answers will be sent to Valley Sports Camp directors.
We look forward to having your child at camp!
Your answer
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