Totus Tuus for People with Special Needs
Monday July 23rd - Friday July 27th 2018
10:00a.m. - 2:00p.m.
Queen of the Holy Rosary
7023 West 71st Street
Overland Park, KS 66204


The Totus Tuus Teams will offer an adapted Totus Tuus program for people with Special Needs! The program is designed for persons ages 6 - adult with intellectul/developmental disabilities.

The Fee is $30 per person or $50 per family.

Registration Deadline is Monday July 2, 2018

Volunteers are needed for the program. If you would like to help, please contact the Office of Special Needs Ministry by email at tracunas@archkck.org or call 913.647.3054 or 316.305.7487.

We look forward to serving you in the Totus Tuus Program!

Email address *
Full Name *
Your answer
Postal Address *
Your answer
City/State/Zip Code *
Your answer
DOB *
MM
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DD
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YYYY
Gender *
Required
Parish *
Your answer
Have you made your First Holy Communion *
Do you receive Holy Communion Weekly? *
Parent/Guardian Name *
Your answer
Home Address (if different from above)
Your answer
City/State/Zip Code (if different from above)
Your answer
Phone Number *
Your answer
Alternate Phone Number *
Your answer
How do you learn best? (touching, seeing, listening, music, videos, doing crafts etc) *
Your answer
Describe your disability *
Your answer
Will you require medication during the time you are attending Totus Tuus (10am-2pm)? *
If you answered YES to medications please provide details.
Your answer
Please check any of the following that are a challenge for you:
If you experience emotional or behavioral difficulties, what kinds of support work best in restoring a sense of calm?
Your answer
Do you use a communication book? *
Is a visual schedule helpful to you? *
Do you have allergies? If yes, please explain. *
Required
If you answered yes to allergies please explain.
Your answer
Do you require special positioning in a chair or wheelchair? *
Do you wear AFOs, prosthetics or braces that will need to be removed or adjusted between 10am - 2pm? If yes, please explain.
Your answer
Do you have seizures? If yes, please describe frequency and any visible warning signs.
Your answer
Do you have any special dietary needs or restrictions during snack time?
Your answer
Do you need assistance with:
If any of the above were checked, please explain.
Your answer
Please provide any other information that would be helpful to us to ensure you are safe and have fun!
Your answer
Please Print, complete and bring the following medical waiver with you on the first day of Totus Tuus.
Your answer
Totus Tuus Medical/Photo Release Form
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