2026 VBS St. Francis Safari Adventure Registration Form

St. Maria Goretti and St. Joseph Parishes St. Francis Safari Adventure

VBS 2026
"Caring for Creation & Others"
July 20 - July 24, 2026

9:00 am - 12:00 pm

Goretti Hall

Registration closes on July 13, 2026.

***Ages 4 years old to 6th grade.***

Please call Kathy Hansen at 219-322-6124 x308

with questions.
Family parish
Father's Name

First NameLast Name
Mother's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father's cell phone:
Please enter a valid phone number.Format: (000) 000-0000.
Mother's cell phone:
Please enter a valid phone number.Format: (000) 000-0000.
Email Address (All email correspondence will be sent to this address.)
example@example.com
Emergency contact name (In case of an emergency and the CFP Office is unable to reach the father or mother.)

First NameLast Name
Relationship to child(ren):
Cell phone:
Please enter a valid phone number.Format: (000) 000-0000.
Non-parent pick-up (please list the person allowed to pick up your child(ren):

First NameLast Name
Relationship to child(ren):
REGISTRATION INFORMATION - How many children are you enrolling in VBS?
Full Name of Child 1

First NameLast Name
Grade completed:
Age:
Birthday

MonthDayYear
Date
Gender
T-shirt size:
Please list any health concerns or allergies:
Please list any additional information (IEP, physical or learning concerns)
Full Name of Child 2

First NameLast Name
Grade completed:
Age:
Birthday

MonthDayYear
Date
Gender
T-shirt size:
Please list any health concerns or allergies:
Please list any additional information (IEP, physical or learning concerns)
Full Name of Child 3

First NameLast Name
Grade completed:
Age:
Birthday

MonthDayYear
Date
Gender
T-shirt size:
Please list any health concerns or allergies:
Please list any additional information (IEP, physical or learning concerns)
Full Name of Children 4

First NameLast Name
Grade completed:
Age:
Birthday

MonthDayYear
Date
Gender
Please list any health concerns or allergies:
Please list any additional information (IEP, physical or learning concerns)
If you are interested in volunteering, please add you name here:

First NameLast Name
Photography and Video Release Consent

Photographs and video may be taken as part of our "VBS" experience. Signing below constitutes persmission for your children's participation in the video or photography which can be posted in the parish bulletin or webpage.
Do you give permission for your child or children to be videotaped and photographed?
Please make your payment below.

VBS Payment

1 Child $20

$20 for one child & a credit card processing fee

$20.60

2 Children $40

$20 for each child and a credit card processing fee

$41.20

3 Children $60

$20 for the each child and a credit card processing fee

$61.80

Total

Credit Card

Should be Empty:

St. Maria Goretti and St. Joseph Parishes St. Francis Safari Adventure

VBS Payment*

Credit Card

VBS Payment