Totus Tuus Registration Form 2021 Family Name* Home PhoneCell PhoneEmergency Contact Name and Number during Totus Tuus hours* Home Address* Street Address Address Line 2 City ZIP / Postal Code Email Address* Group assignments and other vital information will be sent via email. Please provide the email address you check most often Early Childhood Program Pre-K and KindergartenPlease contact Jennifer at jzwiers@sthenryparish.com if you are interested in sending your child. This program will only be offered if enough people are interested. You will be notified on June 18th with details. If not potty-trained, a responsible adult must attend. All adults need to be Virtus trained. Face Masks will be requiredNumber of Children12Name of Child 1 First Name of Child 2 First 1st Child's DOB (Date Of Birth)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119202nd Child's DOB (Date Of Birth)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920School InformationGrade EnteringSchool to add another child's school information please click the plus next to the "School" box.Food Allergies and other concernsGrade School Program 1st - 6th gradeCampers will need to bring a SACK LUNCH and WATER BOTTLE each day! Face Masks will be required. Number of Children123Name of Child 1 First Name of Child 2 First Name of Child 3 First First Childs DOB (Date Of Birth)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Second Childs DOB (Date Of Birth)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Third Childs DOB (Date Of Birth)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920School InformationGrade EnteringSchool to add another child's school information please click the plus next to the "School" box.Food Allergies and other ConcernsTeen Program 7th - 12th *just graduated seniors are welcome too!Face Masks will be required Number of Teens123Name of teen 1 First Name of teen 2 First Name of teen 3 First 1st teens DOB (Date Of Birth)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119202nd teens DOB (Date Of Birth)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119203rd teens DOB (Date Of Birth)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920School InformationGrade enteringSchool to add another child's school information please click the plus next to the "School" box.Food Allergies and other concernsRemember to also fill out a Medical Release Form for EACH child
