Totus Tuus Participant Sign Up 2026

Totus Tuus Participant Sign Up 2026

Hosted by Most Holy Eucharist Parish at St. Patrick Church of Merna
Daytime Program: Grades 1-6 (2026-27 school year)

Dates: Monday through Friday, June 29-July 3, 2026

Time: 9am-2:30pm (drop off NO EARLIER than 8:45am)

Cost: $50 for 1 child; $70 for 2 children; $90 for 3 or more children

Scholarships are available! Please contact Erin at totustuus@mheparish.org for more information.

Payment: After you submit this form, you will be redirected to our online payment page. Your spot is not guaranteed until we have received your payment!

Evening Program: Grades 7-12 (2026-27 school year)

Dates: Sunday through Thursday, June 28-July 2, 2026

Time: 6:30pm-8:15pm

Cost: $15 per teen

Scholarships are available! Please contact Erin at totustuus@mheparish.org for more information.

Payment: After you submit this form, you will be redirected to our online payment page. Your spot is not guaranteed until we have received your payment!
We will be sending out detailed information via email closer to the start date of the program. Please be sure to add totustuus@mheparish.org to your contacts and keep an eye on your junk and promotions folders!
Which parish do you attend?*
Parent's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
opt out
Email*
example@example.com

Child's Name*

First NameLast Name
Birthdate*

MonthDayYear
Date
Grade (Fall of 2026)*
Does your child have any medical or dietary needs or allergies of any kind (food, environmental, seasonal)?*
Is your child currently taking any medications that we need to be aware of or that we will have to administer?*
Does your child have an IEP or require any assistance in the classroom?*
YesNo
If yes, please select your child's t-shirt size:

Child's Name

First NameLast Name
Birthdate

MonthDayYear
Date
Grade (Fall of 2025)
Does your child have any medical or dietary needs or allergies of any kind (food, environmental, seasonal)?
Is your child currently taking any medications that we need to be aware of or that we will have to administer?
Does your child have an IEP or require any assistance in the classroom?
YesNo
If yes, please select your child's t-shirt size:

Child's Name

First NameLast Name
Birthdate

MonthDayYear
Date
Grade (Fall of 2025)
Does your child have any medical or dietary needs or allergies of any kind (food, environmental, seasonal)?
Is your child currently taking any medications that we need to be aware of or that we will have to administer?
Does your child have an IEP or require any assistance in the classroom?
YesNo
If yes, please select your child's t-shirt size:

Child's Name

First NameLast Name
Birthdate

MonthDayYear
Date
Grade (Fall of 2025)
Does your child have any medical or dietary needs or allergies of any kind (food, environmental, seasonal)?
Is your child currently taking any medications that we need to be aware of or that we will have to administer?
Does your child have an IEP or require any assistance in the classroom?
YesNo
If yes, please select your child's t-shirt size:

General Permission
I request that my child(ren) list names* be allowed to attend Totus Tuus located at St. Patrick Church of Merna- program for Most Holy Eucharist Parish, and which takes place June 28-July3, 2026. I hereby release and agree to indemnify and hold harmless the parish, its staff and their employees and agents, volunteers, and the Catholic Diocese of Peoria from any and all liability, for injuries, damages, medical expenses or any other loss to my child or family, including attorney fees, arising from claims of any kind of nature whatsoever from my child(ren)'s participation in this event.
Signature*

Clear
Medical Permission
I grant permission for the administration of First Aid to my child(ren) list names* by the people in charge of the Totus Tuus event, to sign the necessary releases as may be required, and to make the necessary referrals to qualified physicians for the treatment of illness or accidents of a more serious nature. I understand I will be promptly notified in the event of any serious illness or accident and prior to any major surgery, except when delay in such communication would endanger life. In the case of medical emergency, I understand that every effort will be made to contact the parent/guardian of the participant. In the event that I cannot be reached, I hereby give permission to the physicians selected by the adult staff to hospitalize, secure proper treatment for, and to order injection, anesthesia, or surgery if deemed necessary for my child(ren).
Signature*

Clear
COVID-19 Waiver
I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) list names* may be exposed to or infected by COVID-19 by attending Totus Tuus. I understand the risk of becoming exposed to COVID-19 at Most Holy Eucharist Parish Totus Tuus program, and do not hold the Most Holy Eucharist Parish or the Catholic Diocese of Peoria responsible.
Signature*

Clear
Videotaping and Still Photographs Waiver
I acknowledge that video, still photographs, and audio recordings of my child(ren) list names* may be taken during Totus Tuus. This authorization form constitutes permission for my child(ren)'s participation in videotaping, still photographs, and/or audio recordings, which may be used for future promotional efforts, including the Catholic Diocese of Peoria publications and websites.
Signature*

Clear
Insurance Information
Policy Holder (in the name of):*
Insurance Company:*
Policy Number:*
Identification/Group Number:*
Authorized Physician:*
Physician's Phone Number:*
Please enter a valid phone number.Format: (000) 000-0000.
OSF St. JosephCarle BromennNo preference
Emergency Contact Information
In case of emergency, when parents can't be reached, please contact:*

First NameLast Name
Relationship to child:*
Cell Phone Number:*
Please enter a valid phone number.Format: (000) 000-0000.