If you are a HS Transfer, after completing this form you need to call Mrs. Rachel Ellingson, Director of Enrollment - 815-717-3160
Shadow Day Specifics
*Dress Down Days-Students may wear appropriate jeans/shorts and a t-shirt/sweatshirt. Flip flops are NOT allowed.
Parent/Guardian Completing This Form
Please list any medical issues (eg. allergies, diabetic, etc.) or other issues that we should know about:
Emergency Contact Information
Please list an additional person o contact in case of an emergency
Parent /Guardian Permission
In order for your child to attend a Shadow Day visit at Providence Catholic High 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 Providence Catholic High School (PCHS).
I authorize PCHS employees to give normal first aid to my child and understand that PCHS is not to be held liable for the bestowal of such health care.
I hereby release PCHS 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.
This field is for validation purposes and should be left unchanged.