Marianist VILAC 2020 Mail-In Registration Form

ON-LINE AND MAIL-IN REGISTRATION FORM

DUE WEDNESDAY, FEBRUARY 5, 2020

Marianist VILAC 2020
St. Anthony of Padua Church
1627-B Mill St.
Wailuku, HI 96793-1999

Checks payable to St. Anthony Church

(mail to address above; be sure check has VILAC2020 on MEMO line)  WORKSHOP FEE:  ADULTS/YOUNG ADULTS $35.00 per person OR $30.00 if registering with group of 5 or more together).

HS/MS STUDENTS: $25.00 per person OR $20.00 if registering with group of 5 or more together)

Last Name:  __________________________  First Name: ______________________  

Preferred FIRST Name  for Name Badge: ________________________

Home Mailing Address: _________________________________________________

City _________________ State _____ Zip _____

Preferred Phone:  _(____)____________________    Check below as applicable:

            ___ Cell phone above:  can accept text and voice msg

             ___ Landline # above  __ Voice Msg okay   __ NO voice msg.

Preferred email: (please clearly distinguished periods, dashes, zero vs letter etc.) _____________________________________

Name of Parish: _____________________  Group name ________________________

 Workshop Session Choices: CHOICE ONE ONLY (as age appropriate)

  1. ___  ADULT SESSION with Fr. Ricky and Jesse Manibusan, Church Center
  2. ___  YOUNG ADULT SESSION (ages 18+-@39) with EPIC Ministry  of Oahu (Kainoa Furumoto, Malcolm Zara, and Joshua Kapika and friends) “Communication Through Music” SAS Bandroom
  3. ___ YOUTH GROUP SESSION (High school students grades 9-12 and middle schoolers, grades 7-8), with kumu Joe Camacho of Big Island in Flex Learning Center (former library).

Participant Signature ___________________________________________ date _____________

For HS/MS Students: Parental consent also required with signatures

Parent of student _____________________________________________  date _____________

Parent of student _____________________________________________  date _____________

 

QUESTIONS? Contact Rosie Johnson at 808-385-8049  or at vilacmaui@gmail.com