Silicon Valley 5-Day Club registration

The only remaining date available is August 10 – 14

Child’s Name*

Age* (Children age 5 – 12 may attend.)


Additional Child’s Name


Zip Code* (Must be a US resident.)

Parent/Guardian Email*

Home Phone*

My child/children listed on this form are allowed to attend the CEF online 5-Day Club

Parent/Guardian Electronic Signature*

Typing your name here is your legal signature.

We will send information on how to access the online 5-Day Club the Saturday before club begins. For your child’s safety, only children with permission from parents and a completed registration form may attend. All teachers in our clubs have been screened according to the Child Protection Policy of Child Evangelism Fellowship. Please feel free to contact us at if you have any questions.

Note: If an empty green box appears after you click Send, your form has submitted successfully. You do NOT need to resend.