CBCWLA Baptist Church & Iglesia Familiar Nueva Vida 2014 VBS Registration Form
What: Agency D3: Discover. Decide. Defend.

Join Agency D3 Special Agents for a week of fun as they examine eyewitness reports, physical proof, and biblical accounts to uncover and defend the truth about who Jesus really is.

Who: 4-13 years

When: 9:45 AM-3:00 PM,  Aug 4-8, 2014
(Please note that lunch is not provided; please have children bring their own lunches.)

**VBS Graduation/Celebration held on FRIDAY, Aug 8 (6:00 - 7:30 = Potluck Dinner;  7:30 - 9:30 = Graduation)**

Where:1925 Sawtelle Blvd., Los Angeles, CA 90025


To get a better and exciting idea of what VBS is like, please click the following link!
https://www.youtube.com/watch?v=LMjZuSzFFOo

Registration fee:
$35/child for families registering before or on 7/20/14, and
$45/child for families registering after 7/20/14 (financial aid available).

If you have any VBS-related questions, please feel free to contact CBCWLA.

We look forward to serving with and sharing God's love with your children!
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1) Student's Name *
2) Student's Birth Date *
MM/DD/YYYY
3) Student's upcoming grade (in September, 2014) *
(NOT the grade that they just finished)
4) Home Address *
Please also write City, State, and Zip Code
5) Home Telephone # *
(XXX) XXX-XXXX
6) Guardian/Parent's Name *
Can write Chinese if you'd like (可以打中文）
7) Guardian/Parent's Relation to Student *
e.g. "Mother," "Father," "Grandparent, "Uncle," etc.
8) Guardian/Parent's Alternate Telephone #
If you have a cell or work number (XXX) XXX-XXXX
9) Guardian/Parent's E-mail Address
10) Name of church that child/family regularly attends (please write full name, or write "NA" if not applicable) *
Please do not use abbreviations like "CBC". Please write complete name, such as "Chinese Baptist Church of West LA", If child/family does not regularly attend church, please write "N/A" or "Not Applicable."
11) Which time periods will your child be attending VBS? *
Required
12) How did you hear about our VBS program? *
Check all that apply
Required
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