Test Form – Brandon

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Shadow Day

  • Student Information

    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

  • Medical/Emergency Information

    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.
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