I/we (up to 2 lodgers) apply for the free Lodge (up to 1 month) to the Missions as follows:

My name is ______________________________________ AND/OR his/her name is ____________________________________________________________________.

I/we have ministered at the mission field* of ________________________________ in the country of ________________________________ since __________________.

I/we plan to lodge from the date of __________________ to the date of ___________________ for the purpose of _____________________________________________________

I/we believe authentic the Bible, virgin birth of Jesus Christ, vicarious death of Jesus Christ for our sins, sufficient work of the Holy Spirit, Bodily resurrection, and Jesus coming again to establish His Kingdom on earth.

I/we waive any rights to claim against the Missions, Calvary Chapel of Anaheim Hills, Calvary Chapel La Semilla, Calvary Chapel of Costa Mesa, and/or any persons working for the Calvary Chapels, for any accidents or negligence arising from the free lodge.

I/we have two references' email Addresses (1) ______________________________ and (2) _______________________________.

HEREBY, I/we understand and sign on the date of _________________________,

__________________________________(signature) and/or

__________________________________(signature)

p.s. I/we have any other explanation*/comments (if any, please write down)

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

And please send it to email or CCAH Missions, PO Box 27693, Anaheim Hills, CA 92809, USA .