Totus Tuus Permission Slip

- Formation
  - Children & Family Formation
    
    A Family of Faith
    Youth Ministry
    First Communion & Confirmation Prep
    Summer Events
    
    Totus Tuus (Gr 1-12)
    
    Totus Tuus Permission Slip
    
    Extreme Faith Camp (Gr 6-8)
    Steubenville (Gr 8-12)
  - Adult Formation
    
    Young Adult Ministry
    Catholic Watchmen
    Small Groups & Bible Studies
  - Interested in Catholicism
    
    Catholic Q&As (Apologetics)
    Becoming Catholic (RCIA)

The maximum number of form submissions has been reached. This form is currently not available.
- Church of Saint John the Evangelist of Little Canada
  380 Little Canada Rd.
  Little Canada, MN 55117
  651-484-2708
- Totus Tuus Participant Parental Consent Form and Indemnity Agreement
- Parent/Guardian Name REQUIRED Please fill out this field. Please enter valid data.
- Home Address (Number and Street) 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.
- Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Type of Event: 2019 Totus Tuus Program at the Church of Saint John the Evangelist of Little Canada
  
  Duration: June 16-21, as scheduled.
- Student Participants REQUIRED Please fill out this field.
  
  Student 1
  
  Student Participant Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Sex REQUIRED Please fill out this field.
  
  Student 2
  
  Student Participant Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Sex REQUIRED Please fill out this field.
  
  Student 3
  
  Student Participant Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Sex REQUIRED Please fill out this field.
  
  Student 4
  
  Student Participant Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Sex REQUIRED Please fill out this field.
  
  Student 5
  
  Student Participant Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Sex REQUIRED Please fill out this field.
  
  Student 6
  
  Student Participant Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Sex REQUIRED Please fill out this field.
  
  Student 7
  
  Student Participant Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Sex REQUIRED Please fill out this field.
  
  Student 8
  
  Student Participant Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Sex REQUIRED Please fill out this field.
  
  Student 9
  
  Student Participant Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Sex REQUIRED Please fill out this field.
  
  Student 10
  
  Student Participant Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Sex REQUIRED Please fill out this field.
- Permission:
  
  I,
- Parent/Guardian Name REQUIRED Please fill out this field. Please enter valid data.
- grant permission for
- Participant Name(s) REQUIRED Please fill out this field. Please enter valid data.
- to participate in the above named activity and I warrant that my child(ren) is in good health. In consideration of my child(ren)’s participation, I agree to indemnify the above named parish-school and the Archdiocese of Saint Paul and Minneapolis from any claims or law suits brought against the above named parish-school, Archdiocese of Saint Paul and Minneapolis by myself, my child(ren) or others, that arises out of any behavior by my child(ren) at the event/activity described above. I also agree to pay reasonable attorney’s fees or expenses incurred by the parish/school and the Archdiocese in defense of such a claim/suit.
  
  I also hereby waive and release the named church and the Archdiocese of St. Paul/Minneapolis from all claims and liability arising from any acts or omissions by the church, Archdiocese or their agents with regard to any injuries or damages incurred by my child during the ordinary course of the event/activity. This release and waiver shall not apply to claims that may arise from intentional acts.
  
  EMERGENCY MEDICAL TREATMENT: In the event of an emergency, I give permission to transport my child(ren) to a hospital for medical treatment. I wish to be advised prior to any further treatment by a doctor or hospital. In the event of any emergency, if you are unable to reach me at the above numbers, contact
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Medical Information:
- Medication my child(ren) (Specify which child) is currently taking: REQUIRED Please fill out this field. Please enter valid data.
- Allergies (specify by child): REQUIRED Please fill out this field. Please enter valid data.
- Other Medical Conditions: REQUIRED Please fill out this field. Please enter valid data.
- Family Health Plan Carrier Number: REQUIRED Please fill out this field. Please enter valid data.
- Family Doctor Please enter valid data.
- Family Doctor Phone Number: Please enter valid data.
- As Parent or Guardian, I agree to all of the above stated considerations and conditions.
- I Agree Please select this field.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Date REQUIRED Please fill out this field. Please enter a date.
Submit

Totus Tuus Permission Slip

Permission: