Shadow Day Request Form

SHADOW DAY REGISTRATION FORM

Students in the 6th-11th grades can learn first-hand about Atlantic Christian School by experiencing a Shadow Day Visit. Registration is required and space is limited. Visits are scheduled on a first-come, first-served basis. For the 2024-2025 school year, the following dates are designated for Shadow Day visits: October 24, 2024, November 21, 2024, January 30, 2025, February 27, 2025, March 13, 2025, April 10, 2025, and May 29, 2025. To register for a Shadow Day Visit, please fill out and submit the form below.
Student Name*

First NameLast Name
Age*
Gender*

MaleFemale
Current School*
Current Grade*
Please indicate whether you are in College Prep, Honors, or another course-level designation:

College PrepHonorsOther
Please Describe "Other"
Please select your preferred date or dates for your Shadow Day Visit*

Thursday, October 24, 2024Thursday, November 21, 2024Thursday, January 30, 2025Thursday, February 27, 2025Thursday, March 13, 2025Thursday, April 10, 2025Thursday, May 29, 2025
Parent Name*

First NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent Cell Phone*

Area CodePhone Number
Parent Email*
Where the confirmation will be sent to
Do you know a current ACS student in your grade level who you would like to be your host? If not, ACS will find a perfect match.*

YesNo
If yes, Student Host Name:

First NameLast Name
Emergency Contact. Please list an additional person to contact in case of an emergency.*

First NameLast Name
Emergency Contact Phone Number:*

Area CodePhone Number
Emergency Contact's Relationship to Student:*
Parent/Guardian Permission
In order for your child to attend a Shadow Day Visit at Atlantic Christian School, a parent/guardian must READ and AGREE to all of the following statements. I am the parent/guardian of the child listed above and give permission for my child to attend a Shadow Day Visit at Atlantic Christian School (ACS). I authorize ACS employees to give normal first aid to my child and understand that ACS is not to be held liable for the administration of such health care. I hereby release ACS and all its employees from liability and harm arising to my child during this visit to the school. In the event that I cannot be contacted, I hereby give my permission for any necessary emergency treatment that is administered for the welfare of my child.
Permission*

Yes, I have read and agree
Please verify*
Should be Empty:

SHADOW DAY REGISTRATION FORM