2025-26 Shadow Registration

2025-26 Shadow Registration

Thank you for your interest in Chesterton Academy! Please use this form to register your student to shadow at our school.
Chesterton Academy of The Florida Martyrs
5200 Saufley Field Road, Pensacola, Florida 32526
Located in the parish hall of St. Anne parish.

info@chestertonpensacola.org | (850) 378-1303

Students may be dropped off at the church for Mass on Tuesday - Friday,
or at the parish hall (west entrance) on Monday for our assembly.
Fine and performing arts class days:
Drama: Thursday, Friday
Music: Monday, Tuesday, Wednesday
Studio Art: Friday

This is not a curriculum showcase but a true shadow day so that students may experience a day in the life of a Chesterton Academy student. With this in mind, if there is a particular class your student is interested in, please schedule their visit for the appropriate day of the week.
How did you hear about Chesterton Academy of The Florida Martyrs?*

Family / FriendChurch BulletinSchool NewsletterA Faculty or Staff Member from my child's schoolSocial MediaOnline searchOther
Please note your referring friend, parish, school, or other source.
Student Information
Name*

First NameLast Name
Age*
Sex*

MaleFemale
Current Grade*
Priority will be given to current 8th grade students.
Current School*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Requested Shadow Date*

MonthDayYear
Date
Parent Information
Primary Contact Parent or Guardian*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Additional Parent or Guardian

First NameLast Name
Email address
example@example.com
Phone Number
Please enter a valid phone number.
Religious Affiliation
Parish
Emergency Contact

In the event of an emergency, if we cannot reach a parent/guardian while the student is on our campus, please name an emergency contact.
First NameLast Name
Phone Number*
Please enter a valid phone number.
May we include photos and/or video of your student in our school's social media and marketing materials?

YesNo
Permission and Release of Liability
If you would like your student to participate in a shadow day at our school, please sign the following statement of consent and release of liability. As parent or legal guardian, you remain fully responsible for any legal responsibility which may result from any personal actions taken by your youth.

By allowing our student to participate in a shadow day at Chesterton Academy of The Florida Martyrs, we assume all risks and hazards incidental to such participation and do hereby release, absolve, indemnify and agree to hold harmless the Diocese of Pensacola-Tallahassee, Chesterton Academy of The Florida Martyrs, and St. Anne Parish, and their employees, agents, volunteers, and other persons acting on their behalf. Neither the Diocese of Pensacola-Tallahassee, Chesterton Academy of The Florida Martyrs, St. Anne Parish, nor said agents, employees, or volunteers, shall be held financially responsible for any injury, illness or other loss incurred as a direct or indirect result of this activity. We the undersigned have read this release and understand all its terms and execute it voluntarily and with full knowledge of its significance.

EMERGENCY MEDICAL TREATMENT: In the event of an emergency, I/we hereby authorize the Diocese of Pensacola-Tallahassee, Chesterton Academy of The Florida Martyrs, and St. Anne Parish, through their authorized representatives, to transport my child to a hospital or other doctor’s office or medical facility for emergency medical attention. I/We additionally authorize such representatives of the Diocese and/or School to obtain and give consent to whatever medical treatment the representative deems necessary, including the administering of anesthetic and surgery, and do hereby release the Diocese, Chesterton Academy of The Florida Martyrs, and St. Anne Parish, and their authorized representatives from any and all claims which may arise from the above-referenced obtaining and consenting to medical treatment. I/We wish to be advised, if possible, prior to the providing of any non-emergency medical treatment by any physician or hospital.
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2025-26 Shadow Registration

Student Information

Parent Information

Emergency Contact

Permission and Release of Liability