St. John Vianney
Catholic Church, Fishers, IN

A Pastorate of the Diocese of Lafayette-in-Indiana

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Totus Tuus SJV Summer Camp

- Faith Formation

Registration Information:
Sunday, April 24th until Full
$65 per child, No Family Max
The maximum number of form submissions has been reached. This form is currently not available.
- Totus Tuus SJV Summer Camp Registration
- Parent Information:
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Child(s) Information:
- Number of Children You Are Registering REQUIRED Please fill out this field.
  
  Child 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter a date.
  
  My Child Will Be Entering Grade: REQUIRED Please fill out this field. Please enter an integer (number).
  
  In order to better support your child during the camp please indicate if your child has an I.E.P. This information will be kept in confidence and will only be shared with Megan Smith. REQUIRED Please fill out this field.
  
  Is there anything you would like to share in confidence with us that would be helpful for your child's leader to know? (eg. Allergies, Medicines, Social Concerns)
  
  St. John Vianney Catholic Church's designated First Aid Volunteer has my permission to provide the following medicines to my child if they deem it necessary: REQUIRED Acetaminophen Ibuprofen Please call me before administering any medications to my child No, I do not give my consent Please fill out this field.
  
  My child will require specific medication (which I will provide) for the duration of the camp. Please contact me to discuss specifics.
  
  T-Shirt Size For My Child: You will have an opportunity towards the end of the registration form to purchase additional Adult t-shirts for yourself if you would like to. REQUIRED Please fill out this field.
  
  Child 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter a date.
  
  My Child Will Be Entering Grade: REQUIRED Please fill out this field. Please enter an integer (number).
  
  In order to better support your child during the camp please indicate if your child has an I.E.P. This information will be kept in confidence and will only be shared with Megan Smith. REQUIRED Please fill out this field.
  
  Is there anything you would like to share in confidence with us that would be helpful for your child's leader to know? (eg. Allergies, Medicines, Social Concerns)
  
  St. John Vianney Catholic Church's designated First Aid Volunteer has my permission to provide the following medicines to my child if they deem it necessary: REQUIRED Acetaminophen Ibuprofen Please call me before administering any medications to my child No, I do not give my consent Please fill out this field.
  
  My child will require specific medication (which I will provide) for the duration of the camp. Please contact me to discuss specifics.
  
  T-Shirt Size For My Child: You will have an opportunity towards the end of the registration form to purchase additional Adult t-shirts for yourself if you would like to. REQUIRED Please fill out this field.
  
  Child 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter a date.
  
  My Child Will Be Entering Grade: REQUIRED Please fill out this field. Please enter an integer (number).
  
  In order to better support your child during the camp please indicate if your child has an I.E.P. This information will be kept in confidence and will only be shared with Megan Smith. REQUIRED Please fill out this field.
  
  Is there anything you would like to share in confidence with us that would be helpful for your child's leader to know? (eg. Allergies, Medicines, Social Concerns)
  
  St. John Vianney Catholic Church's designated First Aid Volunteer has my permission to provide the following medicines to my child if they deem it necessary: REQUIRED Acetaminophen Ibuprofen Please call me before administering any medications to my child No, I do not give my consent Please fill out this field.
  
  My child will require specific medication (which I will provide) for the duration of the camp. Please contact me to discuss specifics.
  
  T-Shirt Size For My Child: You will have an opportunity towards the end of the registration form to purchase additional Adult t-shirts for yourself if you would like to. REQUIRED Please fill out this field.
  
  Child 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter a date.
  
  My Child Will Be Entering Grade: REQUIRED Please fill out this field. Please enter an integer (number).
  
  In order to better support your child during the camp please indicate if your child has an I.E.P. This information will be kept in confidence and will only be shared with Megan Smith. REQUIRED Please fill out this field.
  
  Is there anything you would like to share in confidence with us that would be helpful for your child's leader to know? (eg. Allergies, Medicines, Social Concerns)
  
  St. John Vianney Catholic Church's designated First Aid Volunteer has my permission to provide the following medicines to my child if they deem it necessary: REQUIRED Acetaminophen Ibuprofen Please call me before administering any medications to my child No, I do not give my consent Please fill out this field.
  
  My child will require specific medication (which I will provide) for the duration of the camp. Please contact me to discuss specifics.
  
  T-Shirt Size For My Child: You will have an opportunity towards the end of the registration form to purchase additional Adult t-shirts for yourself if you would like to. REQUIRED Please fill out this field.
  
  Child 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter a date.
  
  My Child Will Be Entering Grade: REQUIRED Please fill out this field. Please enter an integer (number).
  
  In order to better support your child during the camp please indicate if your child has an I.E.P. This information will be kept in confidence and will only be shared with Megan Smith. REQUIRED Please fill out this field.
  
  Is there anything you would like to share in confidence with us that would be helpful for your child's leader to know? (eg. Allergies, Medicines, Social Concerns)
  
  St. John Vianney Catholic Church's designated First Aid Volunteer has my permission to provide the following medicines to my child if they deem it necessary: REQUIRED Acetaminophen Ibuprofen Please call me before administering any medications to my child No, I do not give my consent Please fill out this field.
  
  My child will require specific medication (which I will provide) for the duration of the camp. Please contact me to discuss specifics.
  
  T-Shirt Size For My Child: You will have an opportunity towards the end of the registration form to purchase additional Adult t-shirts for yourself if you would like to. REQUIRED Please fill out this field.
  
  Child 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter a date.
  
  My Child Will Be Entering Grade: REQUIRED Please fill out this field. Please enter an integer (number).
  
  In order to better support your child during the camp please indicate if your child has an I.E.P. This information will be kept in confidence and will only be shared with Megan Smith. REQUIRED Please fill out this field.
  
  Is there anything you would like to share in confidence with us that would be helpful for your child's leader to know? (eg. Allergies, Medicines, Social Concerns)
  
  St. John Vianney Catholic Church's designated First Aid Volunteer has my permission to provide the following medicines to my child if they deem it necessary: REQUIRED Acetaminophen Ibuprofen Please call me before administering any medications to my child No, I do not give my consent Please fill out this field.
  
  My child will require specific medication (which I will provide) for the duration of the camp. Please contact me to discuss specifics.
  
  T-Shirt Size For My Child: You will have an opportunity towards the end of the registration form to purchase additional Adult t-shirts for yourself if you would like to. REQUIRED Please fill out this field.
  
  Child 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter a date.
  
  My Child Will Be Entering Grade: REQUIRED Please fill out this field. Please enter an integer (number).
  
  In order to better support your child during the camp please indicate if your child has an I.E.P. This information will be kept in confidence and will only be shared with Megan Smith. REQUIRED Please fill out this field.
  
  Is there anything you would like to share in confidence with us that would be helpful for your child's leader to know? (eg. Allergies, Medicines, Social Concerns)
  
  St. John Vianney Catholic Church's designated First Aid Volunteer has my permission to provide the following medicines to my child if they deem it necessary: REQUIRED Acetaminophen Ibuprofen Please call me before administering any medications to my child No, I do not give my consent Please fill out this field.
  
  My child will require specific medication (which I will provide) for the duration of the camp. Please contact me to discuss specifics.
  
  T-Shirt Size For My Child: You will have an opportunity towards the end of the registration form to purchase additional Adult t-shirts for yourself if you would like to. REQUIRED Please fill out this field.
  
  Child 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter a date.
  
  My Child Will Be Entering Grade: REQUIRED Please fill out this field. Please enter an integer (number).
  
  In order to better support your child during the camp please indicate if your child has an I.E.P. This information will be kept in confidence and will only be shared with Megan Smith. REQUIRED Please fill out this field.
  
  Is there anything you would like to share in confidence with us that would be helpful for your child's leader to know? (eg. Allergies, Medicines, Social Concerns)
  
  St. John Vianney Catholic Church's designated First Aid Volunteer has my permission to provide the following medicines to my child if they deem it necessary: REQUIRED Acetaminophen Ibuprofen Please call me before administering any medications to my child No, I do not give my consent Please fill out this field.
  
  My child will require specific medication (which I will provide) for the duration of the camp. Please contact me to discuss specifics.
  
  T-Shirt Size For My Child: You will have an opportunity towards the end of the registration form to purchase additional Adult t-shirts for yourself if you would like to. REQUIRED Please fill out this field.
- Medical Information:
- In Case Of An Emergency Please 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 Maximum 20 characters Please fill out this field. Please enter a phone number.
- Relationship to Child: Please enter valid data.
- We, as parents/guardians of the minor(s) whom we are registering for SJV's Totus Tuus Summer Camp 2022, herby consent and agree to hold harmless St. John Vianney Parish and/or the Roman Catholic Diocese of Lafayette-in-Indiana, Inc., and any and all employees or volunteers thereof, for any accident, injury or occurrence arising out of, or in connection with the aforementioned activity.
- I agree: REQUIRED I have read and understood the consent to hold harmless St. John Vianney and the Diocese of Lafayette-in-Indiana. Checking this box will be the same as a signature. Please fill out this field.
- I give my permission for my son/daughter, in case of an emergency, to be taken to a physician or hospital by either a parent in charge or by parish personnel. I understand that every effort will be made to contact me and/or the emergency contact person whose information I have provided. If neither of us can be reached, I hereby give permission to the physician selected by the parish member in charge or adult chaperone(s) to secure proper treatment for my son/daughter.
- I agree: REQUIRED I have read and understood the consent to medical treatment if I and/or the Emergency Contact I have provided are unable to be reached. Checking this box will be the same as a signature. Please fill out this field.
- Accident/Hospitalization Policy Name: REQUIRED Please fill out this field. Please enter valid data.
- Policy Number: REQUIRED Please fill out this field. Please enter valid data.
- I give my consent and understand that photos of my child may be used for various types of media including parish media (website, bulletin, Narthex T.V), SJV's Facebook and Instagram, The Catholic Moment. No names will be used.
- I have read and understood the consent to release of my child's pictures. REQUIRED Please fill out this field.
- Volunteer and Snack Information:
- We are excited that your child will be attending summer camp at SJV. We rely on volunteer help to bring this enriching experience to our parish for your child. In which of the following areas will you be helping?
- I am interested in helping in these ways (check all that apply), REQUIRED Initial Set Up End of Week Clean Up First Aid/Medication (Morning) First Aid/Medication (Evening) Set Up (Morning) Set Up (Evening) Clean Up (Morning) Clean Up (Evening) Help at Check In/Out Table (Morning) Help at Check In/Out Table (Evening) Classroom Aide (Morning) Help with Activities (Morning) Help with Activities (Evening) I am unable to help Please fill out this field.
- All families are being asked to bring a snack item to share during the week. Quantity information will be coming soon.
- I will bring: REQUIRED Please fill out this field.
- Would you like to be a host family for our Totus Tuus Missionaries? You would host either 2 male, or 2 female Missionaries at your home from Sunday, July 10 - Friday, July 15.
- Yes, I would like to be considered as a host family.
- I would like to purchase additional adult sized T-Shirts for $12.00 each REQUIRED Please fill out this field.
  
  Additional Adult T-Shirt 1
  
  T-Shirt Size
  
  Additional Adult T-Shirt 2
  
  T-Shirt Size
  
  Additional Adult T-Shirt 3
  
  T-Shirt Size
  
  Additional Adult T-Shirt 4
  
  T-Shirt Size
- Payment Information:
- Regular Registration for Everyone:
  Sunday, April 24th until Full
  $65 per child, No Family Max
- How would you prefer to submit payment? REQUIRED Please fill out this field.
- Please Note: Your registration is not complete until payment has been received.
  
  You may drop off exact cash or a check in the Office Monday - Friday, 9 am - 3 pm. You may also deposit it in the secure black maildrop located on the exterior of the building, on the concrete post facing the main entrance doors.
  
  Mailing Address: St. John Vianney Catholic Church, 15176 Blessed Mother Blvd., Fishers, IN
  
  Online Payment: Our Sunday Visitor
- Please click the submit button below to submit your registration information.
  Clicking the online payment thru Our Sunday Visitor does not submit your registration it only directs you to the online payment page. Thank You!
Submit

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Totus Tuus SJV Summer Camp

Registration Information: Sunday, April 24th until Full $65 per child, No Family Max

Totus Tuus SJV Summer Camp Registration

Medical Information:

In Case Of An Emergency Please Contact:

Volunteer and Snack Information:

Payment Information:

Registration Information:
Sunday, April 24th until Full
$65 per child, No Family Max