Totus Tuus

TOTUS TUUS
Parents name *

First Name Last Name
Child/Youth's name

First Name Last Name
birthdate
Phone Number

Area Code Phone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
School *
Allergies or Medical Conditions *
Please indicate T-shirt size using (Y) youth, (A) adult along with Sm. Med. Lg. XL
blanks
Child/youth entering gr. 1-6 $75.00
2 children/youth $100.00
3+ children/youth $125.00
Jr/Sr High youth entering gr. 7-12- $25.00

Grade School Program- M-F 9:00 AM- 2:30 PM July 19th-23rd
Jr/Sr High Program- Sun.-Thurs. 7:00 PM- 9:15 PM July 18th-22nd
I am registering my child for- *

Grade school program, children entering grades 1-6 Jr/Sr High Program, youth entering grades 7-12
You will need a separate registration form for each child
Do you have any COVID-specific concerns that we should be aware of? Please explain.
Emergency Contact

First Name Last Name
Phone Number

Area Code Phone Number

AUTHORIZATION, CONSENT AND RELEASE FOR USE OF VISUAL LIKENESSES AND ORIGINAL WORKS OF MINORS

This form allows you, the parent or guardian, to identify if images of your child and their original works may be used for purposes of print, online, social media communication and promotion.
I am the parent or legal guardian of (full name of minor) (“My Child”).* ("My Child").
I grant the following rights to Our Lady of the Lake Catholic Church and the Archdiocese of Saint Paul and Minneapolis:

1.     The right to use all photographs, pictures, portraits, vocal sounds, appearances/likenesses, video and performances (hereinafter collectively known as “image”) of My Child in the possession of Our Lady of the Lake Catholic Church;

2.     The right to use, reproduce, publish, exhibit, distribute, and transmit the image of My Child individually or in conjunction with other images or printed matter in the production of brochures, slides, motion pictures, broadcasts (radio, television, and other social and digital media), audio or video files, recordings, still photography, CD-Rom and any other manner of media now known or later developed;

3.     The right to use, reproduce, publish, exhibit, distribute, and transmit the image of My Child individually or in conjunction with other images or printed matter Our Lady of the Lake Catholic Church and the Archdiocese of Saint Paul and Minneapolis’s Internet websites. No home address or phone number will be published;

4.     The right to record, reproduce, amplify, edit, and simulate My Child’s image and all sound effects produced;

5.     The right to copyright, in the name of Our Lady of the Lake Catholic Church and the Archdiocese of Saint Paul and Minneapolis, works that contain the image of My Child;

6.     The right to use and publish for general communications, advertising, commercial or publicity purposes, or for any other lawful purpose whatsoever My Child’s original work; and

7.     The right to assign the above-mentioned rights to third parties without notice to me.

I understand that the video files, still photos, or other media incorporating the image of My Child will become the property of Our Lady of the Lake Catholic Church. I hereby waive the right to inspect or approve the image or any finished materials that incorporate the image.

I understand and agree that no compensation will be provided, now or in the future, in connection with the use of My Child’s image or My Child’s original work.

I hereby release, discharge, and agree to indemnify and hold harmless Our Lady of the Lake Catholic Church , the Archdiocese of Saint Paul and Minneapolis, and their agents, employees and assigns from any and all claims, demands, right, and causes of action of whatever kind that I or My Child have or may have or may arise by reason of this authorization and from the use of My Child’s image and original work, including but not limited to, all claims for libel and invasion of privacy.

This consent regarding My Child’s likeness and original work is valid until such time as I choose to rescind this authorization and consent. If I choose to rescind this authorization and consent, I agree that I will inform Our Lady of the Lake Catholic Church in writing and that my rescission will not take effect until it is received by Our Lady of the Lake Catholic Church. I understand and acknowledge that it may not be possible to recall any work or photos that have been published prior to receipt of my written rescission.
I hereby authorize and consent that Our Lady of the Lake Catholic Church and the Archdiocese of Saint Paul and Minneapolis have the right to use My Child’s name in connection with their educational, promotional, fund-raising activities, or for any other legitimate purpose. By selecting an option and typing my initials below, I acknowledge and agree this electronic or digital signature is the legally binding equivalent to my handwritten signature. This electronic or digital signature has the same validity and meaning as my handwritten signature. By typing my signature below as guardian, I acknowledge and agree to the conditions above. *

Yes No
Signature of Parent/Guardian: By signing my signature below, I acknowledge and agree this electronic or digital signature is the legally binding equivalent to my handwritten signature. This electronic or digital signature has the same validity and meaning as my handwritten signature. By typing my signature below as guardian, I acknowledge and agree to the conditions above.Electronic Signature *

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Parent First & Last Name *

First Name Last Name
Date *

Month Day Year
Date

DISCLOSURE,AUTHORIZATION AND CONSENT FOR SOCIAL MEDIA OR OTHER ELECTRONIC COMMUNICATION INVOLVING MINORS
I am the parent or legal guardian of (full name of minor) (“My Child”).* ("My Child").
In order to ensure transparency and parental involvement, Our Lady of the Lake Catholic Church has created this consent form so that parents and guardians may provide authorization for Our Lady of the Lake Catholic Church leaders to electronically communicate with minors. Such communications must comply with applicable Our Lady of the Lake Catholic Church policies, including restrictions on private communications with minors.

I grant permission for staff or other leaders of Our Lady of the Lake Catholic Church to communicate with My Child electronically. I understand that such communications are for Our Lady of the Lake Catholic Church purposes only and may involve group communications relating to Our Lady of the Lake Catholic Church activities. Further, I understand and authorize that such electronic communications may be made via text, email, telephone and cell phone, social media, digital networking, and other electronic means.

I acknowledge that to review or receive public communications shared via social media with My Child, I will need to have an account with the same social media platforms or become a fan or follower of the same social media. I also understand that communications may be accessible or viewable by others who are also fans or followers of the same social media.

This Disclosure, Authorizations, and Consent form is valid for one year.

If I choose to rescind this authorization and consent, I agree that I will inform Our Lady of the Lake Catholic Church in writing and that this rescission will not take effect until it is received by Our Lady of the Lake Catholic Church.
Parent/Guardian Phone *

Area Code Phone Number
Child Email Address (Confirmation and older)
example@example.com
Date *

Month Day Year
Date

Our Lady of the Lake Novel Coronavirus Acknowledgement & Assumption of Risk
I acknowledge and understand, the novel coronavirus, COVID-19 has been declared a worldwide pandemic by the World Health Organization. Further, that COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. I also acknowledge, that federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited or limited the congregation of groups of people.

I agree, represent and warrant that neither the undersigned, nor any registered participant child(ren) shall visit or utilize the facilities, programs, activities, or services of Our Lady of the Lake Catholic Church within 14 days after (1) returning from outside the United States, (2) exposure to any person returning from outside the United States, or (3) exposure to any person who has a suspected or confirmed case of COVID-19.

I hereby agree, represent and warrant that neither the undersigned nor any registered participant child(ren) shall visit or utilize the facilities, programs, activities, or services of Our Lady of the Lake Catholic Church if he or she (1) experiences symptoms of COVID-19, including, without limitation, fever, cough or shortness of breath, or (2) has suspected or diagnosed/confirmed case of COVID-19. The undersigned agrees to notify Our Lady of the Lake Catholic Church immediately if any of the foregoing access or use restrictions may apply.

Our Lady of the Lake Catholic Church has put in place preventative measures to reduce the spread of COVID-19. I agree to comply with measures that Our Lady of the Lake Catholic Church may require to best protect against the introduction of viruses at Our Lady of the Lake Catholic Church , including, but not limited to, hygiene practices and temperature screening, related to myself and/or my child(ren). Our Lady of the Lake Catholic Church cannot guarantee that my child(ren) will not become infected with COVID-19. I understand and agree that attending Our Lady of the Lake Catholic Church could increase my risk and my child(ren)’s risk of contracting COVID-19.

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by participating in programs of or attending Our Lady of the Lake Catholic Church and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at Our Lady of the Lake Catholic Church may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Our Lady of the Lake Catholic Church employees, volunteers, and program participants and their families.
Signature of Parent/Guardian: By signing my signature below, I acknowledge and agree this electronic or digital signature is the legally binding equivalent to my handwritten signature. This electronic or digital signature has the same validity and meaning as my handwritten signature. By typing my signature below as guardian, I acknowledge and agree to the conditions above. Electronic Signature *

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TOTUS TUUS

AUTHORIZATION, CONSENT AND RELEASE FOR USE OF VISUAL LIKENESSES AND ORIGINAL WORKS OF MINORS

DISCLOSURE,AUTHORIZATION AND CONSENT FOR SOCIAL MEDIA OR OTHER ELECTRONIC COMMUNICATION INVOLVING MINORS

Our Lady of the Lake Novel Coronavirus Acknowledgement & Assumption of Risk

Volunteer Opportunities