MCA Middle School Shadow Day Registration

Please complete the following form and note the important information. We look forward to hosting your student as they consider Metro Christian Academy for their future.

The middle school shadow experience will begin at 8:30am. Please have your student arrive in the Admissions Office no earlier than 5-10 minutes prior to their start time. They will meet their host at 8:35am and will go to classes, chapel, and lunch, which will be provided by our cafeteria. They may bring their own lunch if they would prefer.

Shadow students should wear simple/non-ripped jeans or pants and a solid color shirt without writing on it. A sweater or sweatshirt is always a good idea too as some classes can be cooler than others. Athletic shoes are allowed.

Pick up will be at 12:00pm in the Admissions Office.

Shadow Student Name Shadow Student Name First Last
Student Gender

Student Gender Male Female
Current School
Current Grade

Current Grade 5th 6th 7th
List extracurricular and honors/on-level interests
Anything else you'd like to share:
Parent/Guardian Name Parent/Guardian Name First Last
Parent/Guardian Phone Number Parent/Guardian Phone Number - ### - ### ####
Parent/Guardian Email
Primary Address Primary Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Emergency Contact

This following persons may be called in case of illness or accident if the parents cannot be reached:
Physician Name Physician Name First Last
Physician Phone Number Physician Phone Number - ### - ### ####
Relative/Friend Name Relative/Friend Name First Last
Relative/Friend Phone Number Relative/Friend Phone Number - ### - ### ####
Health Record

Please list any health issues, medications, or allergies that require special attention
Consent and Digital Signature

In the event that an emergency should arise, I hereby grant the representative of Metro Christian Academy my permission to do whatever is necessary to ensure the safety and well-being of my child, including, but not limited to, obtaining and authorizing student medical treatment. All responsibility for a visiting student's medical expense is assumed by the parents/guardians.
Parent/Guardian Legal Name

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

MCA Middle School Shadow Day Registration

MCA Middle School Shadow Day Registration

Emergency Contact

Health Record

Consent and Digital Signature