Totus Tuus Registration

IMPORTANT NOTE: After you submit the registration, please close the window on your phone/computer so that the registration is not submitted more than once.

Cost of the program is $40 per student with a $120 family maximum.

Parish --- If you are not a parishioner of the parish selected, please check with the parish Totus Tuus leader for availability before registering your students.

Select your parish*

Choose participation*

Volunteer Options. Please select

Volunteer Option - choose day(s) of the week to volunteer

Parent (Guardian) / Volunteer Name*

First NameLast Name

Parent(Guardian) / Volunteer E-mail*

example@example.com

Parent (Guardian)/ Volunteer Phone Number*

Please enter a valid phone number.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Volunteer T-Shirt size

Student Information (Note: Choose students grade on April 1, 2026)*

	Student Name	Gender	Grade 2025/2026	T-Shirt size

Student Name 1

Student 1 - if filled=40/ not filled - empty

Student Name 2

Student 2 - if filled=40/ not filled - empty

Student Name 3

Student 3 - if filled=40/ not filled - empty

Student 4- if filled empty/not filled empty

Student 5- if filled empty/not filled empty

Student 6- if filled empty/not filled empty

total cost

Coupon Code

Emergency Contact*

First NameLast NameRelationship

Emergency Contact Phone Number*

Please enter a valid phone number.

Medical Authorization / Release of Liability:
I/We, as the parents/legal guardian of the above-named participants, hereby grant the Diocese of Grand Island, their staff, parish, parish staff, and volunteers permission to transport this minor to an emergency medical or health care facility for immediate treatment and/or consultation, if deemed necessary. I/We understand that I/we will be notified of any emergency situation. I/We give authorization to the attending physician, dentist, or medical personnel for any required immediate treatment in the event that I/we cannot be reached at the time of the emergency. I/We agree to be financially responsible for any and all medical expenses and/or treatment costs and all related services provided to the above mentioned participants, and I/We release the Diocese of Grand Island, their staff, parish, parish staff, and volunteers from any liability.

I/We understand that this event is sponsored by the Diocese of Grand Island but is a program through my parish. I/We hereby grant permission for My/Our son/daughter to participate in Totus Tuus and accept full responsibility for any legal or financial consequences which may result from any personal actions (ie. damage to property or other participants/staff/volunteers) taken by My/Our son/daughter, and I/We agree to hold the Diocese of Grand Island, their staff, parish, parish staff, and volunteers harmless with respect to any actions or claims that may be made in connection with personal actions taken by My/Our son/daughter. I/We also grant permission for the Diocese of Grand Island, their staff, parish, parish staff, and volunteers to use photos and videos of My/Our son/daughter for publicity/marketing purposes.

I/We authorize the release of information to My/Our insurance company and family physician.

Note any ALLERGIES:*

(including food allergies)

Note any MEDICAL CONDITIONS:*

(including mental health or pregnancy)

Note any current MEDICATIONS:*

Include OTC

Please indicate:*

I DO give permission for my/our child(ren) to be given over-the-counter treatments (such as Tylenol, Tums, Sudafed, etc) if she/he experiences discomfort and requests treatment.I DO NOT give permission for my/our child(ren) to be given over-the-counter treatments (such as Tylenol, Tums, Sudafed, etc) if she/he experiences discomfort and requests treatment.

Parent/Guardian Signature*

Date*

Date

Total Cost (non-refundable fee)*

USD($120 family maximum Totus Tuus)

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

NOTE: if you have an extra box at the end of the payment section, enter your billing zip code.

Please close your window after submission to prevent duplicate charges

Totus Tuus Participant / Volunteer Registration