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Registration - Vision 20/20 - Celebration

- Evangelization

Bishop Zinkula invites you to Celebrate the Vision of our Evangelization efforts!

June 14, 2020 - St. Patrick in Iowa City

Please refer to the Diocese of Davenport Events website for details.
Registration deadline is May 22, 2020.
If you have any questions or need assistance, contact Barb Butterworth.
Registration form
The maximum number of form submissions has been reached. This form is currently not available.
- In order for us to be able to plan appropriately, all adults, youth and children are to be registered.
  This is a space limited event. If you are interested in attending, please contact your pastor/parish office before you register.
  Contact information is needed for each adult.
  
  Nametags will be printed using the spelling noted on this form.
- Number of adults attending REQUIRED Please fill out this field.
  
  Adult 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Mobile Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Adult 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Mobile Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Adult 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Mobile Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Adult 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Mobile Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Your parish: REQUIRED Please fill out this field.
- If Other, please specify. Please enter valid data.
- All children are welcome throughout the celebration!
  There is no childcare, however there will be supervised activities for children ages 5-12 during the guest speakers' presentations.
- Number of children/youth attending REQUIRED Please fill out this field.
  
  Child's name/age # 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Child's name/age # 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Child's name/age # 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Child's name/age # 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Child's name/age # 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Child's name/age # 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Child's name/age # 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Child's name/age # 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Child's name/age # 9
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Child's name/age # 10
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
- Low-gluten Host needed
- Dinner menu:
  Slow smoked pulled pork sandwich
  Fresh mixed salad greens with choice of dressings
  BBQ baked beans, Potato salad
  Cookies, Assorted beverages
  Unfortunately special dietary requests are not an option.
- I/We will be staying for dinner. REQUIRED Yes No Please fill out this field.
- For clergy only. Please check all that apply. Priest Deacon I will be vesting for Mass (bring alb and white stole). I am able to assist with communion if needed.
- If your plans change and you are unable to attend, please let us know so that we can plan accordingly.
  I understand that I should let you know if I need to cancel. Please select this field.
- A freewill donation
  
  Your donation to help cover the costs of this celebration is greatly appreciated. You can donate at the celebration with cash or check, or you can donate online now. A link to donate now will be provided once you submit your registration.
  
  Thank you for your generous contribution!
- Select Submit in order to complete your registration.
Submit

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Registration - Vision 20/20 - Celebration

This is a space limited event. If you are interested in attending, please contact your pastor/parish office before you register.