VBS/Totus Tuus Registration

# of Grade 1-6 Children to Register REQUIRED Please fill out this field.
Child Info 1
- First Name of Child REQUIRED Please fill out this field. Please enter valid data.
- Last Name of Child REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Male Female Please fill out this field.
- Grade in Fall 2022 REQUIRED Please fill out this field. Please enter valid data.
- Allergies or anything we need to know to help your child:
- For the safety of your child(ren) - If your son or daughter has food allergies (other than peanut) and cannot have the provided snack and lunch, please supply your own non-refrigerated snack and lunch. THANK YOU!
- T-Shirt Size (youth): REQUIRED Please fill out this field.
- Special Needs Buddy My son/daughter needs one-on-one assistance from a Special Needs Buddy
- _______________________________________________
Child Info 2
- First Name of Child REQUIRED Please fill out this field. Please enter valid data.
- Last Name of Child REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Male Female Please fill out this field.
- Grade in Fall 2022 REQUIRED Please fill out this field. Please enter valid data.
- Allergies or anything we need to know to help your child:
- For the safety of your child(ren) - If your son or daughter has food allergies (other than peanut) and cannot have the provided snack and lunch, please supply your own non-refrigerated snack and lunch. THANK YOU!
- T-Shirt Size (youth): REQUIRED Please fill out this field.
- Special Needs Buddy My son/daughter needs one-on-one assistance from a Special Needs Buddy
- _______________________________________________
Child Info 3
- First Name of Child REQUIRED Please fill out this field. Please enter valid data.
- Last Name of Child REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Male Female Please fill out this field.
- Grade in Fall 2022 REQUIRED Please fill out this field. Please enter valid data.
- Allergies or anything we need to know to help your child:
- For the safety of your child(ren) - If your son or daughter has food allergies (other than peanut) and cannot have the provided snack and lunch, please supply your own non-refrigerated snack and lunch. THANK YOU!
- T-Shirt Size (youth): REQUIRED Please fill out this field.
- Special Needs Buddy My son/daughter needs one-on-one assistance from a Special Needs Buddy
- _______________________________________________
Child Info 4
- First Name of Child REQUIRED Please fill out this field. Please enter valid data.
- Last Name of Child REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Male Female Please fill out this field.
- Grade in Fall 2022 REQUIRED Please fill out this field. Please enter valid data.
- Allergies or anything we need to know to help your child:
- For the safety of your child(ren) - If your son or daughter has food allergies (other than peanut) and cannot have the provided snack and lunch, please supply your own non-refrigerated snack and lunch. THANK YOU!
- T-Shirt Size (youth): REQUIRED Please fill out this field.
- Special Needs Buddy My son/daughter needs one-on-one assistance from a Special Needs Buddy
- _______________________________________________

Parent/Guardian Info

Parents/Guardians First & Last Name: REQUIRED Please fill out this field. Please enter valid data.
Address: REQUIRED Please fill out this field. Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.
Email REQUIRED Please fill out this field. Please enter an email address.
Home Phone: REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Father's Cell Phone: Maximum 20 characters Please enter a phone number.
Mother's Cell Phone: Maximum 20 characters Please enter a phone number.

_______________________________________________

Emergency Contact Info

Emergency Contacts (if parents/guardians cannot be contacted):
First & Last Name REQUIRED Please fill out this field. Please enter valid data.
Phone Number REQUIRED Please fill out this field. Please enter valid data.

_______________________________________________

Transportation

I am responsible for the transportation of my child to and from St. Vincent's for Totus Tuus. Please select this field.

No Refunds

I/We understand there are NO REFUNDS AFTER MAY 31, 2022 Please select this field.

Photograph Permission I/We release my/our child's photograph(s) to St. Vincent de Paul for their use (names will not be used with photographs)

Registered Parishioner Check if you are a registered parishioner

Parent/Guardian's signature (type name): REQUIRED Please fill out this field. Please enter valid data.

Email for Receipt REQUIRED Please fill out this field. Please enter an email address.