Totus Tuus Registration

Totus Tuus Registration

Please use the following form to register for Totus Tuus!

Totus Tuus Registration Form

Parent/Guardian Name(Required)
Children Participating in Totus Tuus(Required)
Name of Children (first and last)
Allergies, medication, dosage, special needs
Grade level for 2023-2024
please click the plus icon to add more children


Name and phone number of an adult to reach in case of emergency in the event that you cannot be reached at the numbers above.
Name of Family Physician(Required)

Medical Authorization

I understand that the Catholic Diocese of Jefferson City and Totus Tuus assume no responsibility for accidents which may occur in association with diocesan events and activities. I agree to use my/our personal insurance to cover any such incidents. I understand that, in the event medical intervention is needed, every attempt will be made to contact the persons listed above. In the event those individuals cannot be reached, I/We hereby give permission to the physician or any other qualified medical staff selected by the event leader to hospitalize, secure medical treatment, and/or order injection, anesthesia, or surgery for Participant as deemed necessary.

Permission for Other Medical Matters

In the event it comes to the attention of the Diocesan and/or parish chaperones that my child complains of illness, I grant permission for non-prescription medication (such as Tylenol, lozenges, etc.) to be given to Participant.
I give consent for the following non-prescription medication as needed:
check all that apply

Release of Liability for Youth and Adults

I understand all reasonable safety precautions will be taken at all times by the Catholic Diocese of Jefferson City and Totus Tuus and its employees and agents during the events and activities. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree to indemnify and hold harmless the Catholic Diocese and Totus Tuus, its leaders, employees and volunteer staff from any and all claims arising from or in connection with attending this event.

Code of Behavior for Youth and Adults

I agree to abide by and/or instruct my child to abide by all rules and regulations as outlined by the aforementioned chaperones/representatives. I agree that if I/Participant fail(s) to abide in any way by the rules, that I/Participant can be dismissed from the event and sent home immediately at my/Participant’s expense with no right of reimbursement or refund for any amount in connection therewith from the Catholic Diocese of Jefferson City or its chaperones/representatives.

Photo release

I hereby authorize the Catholic Diocese of Jefferson City and Totus Tuus and its agents to utilize photographic and/or video images of me or my child by the Catholic Diocese of Jefferson City. In giving my consent, I hereby indemnify and hold harmless the Catholic Diocese of Jefferson City and Totus Tuus and its agents from any and all responsibility of liability. I understand that I will receive no compensation should any photograph and/or video of me or my child be used.
Parent Photo Release Consent(Required)
MM slash DD slash YYYY


You may click below to pay Totus Tuus fees online; if you do not wish to pay online, click the button below and skip the payment page -you can place a check - made out to "Holy Rosary Religious Education" or cash in an envelope marked "Totus Tuus" in the basket at church or mail to:

Holy Rosary Church
Attn: Donna Long
405 S. Main St.
Monroe City, MO 63456

Payment Method(Required)