Totus Tuus Registration Please complete this form to register your child for Totus Tuus. Student Last Name(Required) Student First Name(Required) Grade (Fall 2023)(Required) 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade Please select the grade your child will be in as of September 2023.Parent/Guardian Last Name(Required) Parent/Guardian First Name(Required) Email Address(Required) Please enter the best email address at which to reach your family.Phone Number(Required) Please enter the best phone number at which to reach your family.Dietary Restrictions(Required) Please list any Dietary Restrictions and/or Food Allergies. If none, please write "none" in the blank belowMedical Release(Required) I consent In the event the undersigned cannot be reached and in the judgment of the Director of Lifelong Faith Formation or other person responsible for the program or other appropriate staff member, there is a necessity for immediate examination and/or treatment of my (our) child, I (we) hereby request and authorize any of the aforesaid personnel to obtain for my (our) child such medical services as are deemed necessary. I agree to assume the financial responsibility for any diagnosis/treatment and for medication deemed necessary.Emergency Contact Person(Required) In the event that the parent/guardian cannot be reached in case of an emergency situation, please list a name (First and Last) and phone number of a emergency contact person.Photo Release(Required) I consent I do not consent As parent/guardian I grant my permission for St. Julie Billiart and St. George Catholic Churches to use any photos, videos or audio recordings of my son/daughter for the purposes of promotion and advertising at either aforementioned parish.Day Camp Registration Fee (Grades 1-6) Quantity(Required) Price: $50.00 Quantity Evening Camp Registration Fee (Grades 7-12) Quantity(Required) Price: $15.00 Quantity Total Payment Method*PayPal CheckoutCredit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name
