CCIC-Cupertino Children's Program Registration Form For 2018 Summer Program and/or 2018-2019 AWANA
Please input the accurate information. Your registration will NOT be confirmed until you come to church (10455 Bandley Dr, Cupertino, CA 95014) and pay the registration fee (checks only) and fill up a Liability Release form with the medical insurance policy # on the following dates:

April 22 (Sunday主日中午 12:30-1:00 pm) April 27 (Friday週五晚上 7:30-8:00 pm)
April 29 (Sunday 主日中午12:30-1:00 pm)May 11 (Friday週五晚上 7:30-8:00 pm)

Summer Program Registration Fee (Non-refundable) 暑期節目報名費(不设退回) :
$45 / child / family 每家一個孩子45元
$85 / two children / family 每家兩個孩子共85元
$120 / three children / family 每家三個孩子共120元

Summer Program Material Fee for the following classes 暑期班特別附加費用:
(A) Musical Play $20 / child 兒童音樂劇 每人20元
(B) Kid’s cooking $20 / child 兒童烹飪每人20元
(C) LEGO Programing $20 / child 兒童樂高編程 每人20元

Awana Registration Fee (Non-refundable) Awana報名費(不设退回) :
$40 / child / family. Books, Bible, Uniform are not included 每名孩子40元。書本、聖經及制服不包括在內。

*Requirement: Parents are required to stay in church while their children are attending their classes. You are invited to join any of the following classes: Gospel Groups or Fellowship Groups.

Email address *
Legal Guardian-1's Relationship 法定监护人-1 与孩子关系 *
Legal Guardian-1's First Name 法定监护人-1 名 *
Your answer
Legal Guardian-1's Last Name 法定监护人-1 姓 *
Your answer
Chinese Name ( If none, answer with N/A) 法定监护人-1中文姓名 *
Your answer
Legal Guardian-1's Marital Status 法定监护人-1婚姻狀況 *
Legal Guardian-1's Current Status 法定监护人-1生活狀況 *
Legal Guardian-1's email address 法定监护人-1電郵 *
Your answer
Legal Guardian-1's cell phone 法定监护人-1手機號碼 *
Your answer
Legal Guardian-1's work phone 法定监护人-1公司電話
Your answer
Legal Guardian-1's Faith 法定监护人-1信仰 *
Legal Guardian-1's church 法定监护人-1所屬教會 *
Legal Guardian-1's Fellowship Group 法定监护人-1所屬團契 *
Legal Guardian-2's Relationship 法定监护人-2 与孩子关系 *
Legal Guardian-2's First Name 法定监护人-2名 *
Your answer
Legal Guardian-2's Last Name 法定监护人-2姓 *
Your answer
Chinese Name ( If none, answer with N/A) 法定监护人-2中文姓名 *
Your answer
Legal Guardian-2's Marital Status 法定监护人-2婚姻狀況 *
Legal Guardian-2's Current Status 法定监护人-2生活狀況 *
Legal Guardian-2's email address 法定监护人-2電郵 *
Your answer
Legal Guardian-2's cell phone 法定监护人-2手機號碼 *
Your answer
Legal Guardian-2's work phone 法定监护人-2公司電話
Your answer
Legal Guardian-2's Faith 法定监护人-2信仰 *
Legal Guardian-2's church 法定监护人-2所屬教會 *
Legal Guardian-2's Fellowship Group 法定监护人-2所屬團契 *
I agree to stay at church while my kid is attending the class 当我的孩子在CCIC参加活动时,我愿意留在教会 *
Kid's Current Status 孩子现况 *
Kid's First Name 名 *
Your answer
Kid's Last Name 姓 *
Your answer
Kid's Chinese Name 中文姓名
Your answer
Kid's Current Grade 現在(2018年4月到6月)就讀年級 *
Kid's Gender 性別 *
Kid's Date of Birth 出生日期 *
Kid's School 學校 *
Your answer
Kid's Food Allergies 過敏食物 *
Kid's Special Need 特別需要
Your answer
Kid‘s Home Address 孩子住址 *
Your answer
Kid's Home Phone 孩子家居电话 *
Your answer
Kid's Summer Friday Night Class Option 1 周五晚暑期班首選 *
Kid's Summer Friday Night Class Option 2 周五晚暑期班次選 *
Registering for 2018 - 2019 Awana (September 7, 2018 - June 14, 2019) 报名参加2018 - 2019 Awana (2018年9月7日至2019年6月14日) *
Every Friday 7:30 PM ~9:30 PM (see for more information)
Registering for 2nd kid 为第二名孩子註册 *
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