"Be a Lion for a Day"
Fill out this form to register your son or daughter for a shadow day at Mount Airy Christian Academy. You will be asked to complete a separate form for each child.
Schedule a shadow date
Pick any of the following dates.
Requested Date: (Thursdays Only)
Student Information
First Name *
Last Name *
Gender
Clear selection
Current Grade Level *
Enrollment year of interest *
Please note any health problems, physical handicap, allergen, or medical need which may limit full participation in any activity, including inhalers, EpiPens, medications, etc.
Students hobbies/interests
Parent/Guardian Information
First name *
Last Name *
Email Address *
Best Phone Number *
Emergency Contact
Name and Cell Phone if possible
If unable to be reached in case of an emergency, I hereby give permission to the physician selected by the school to provide necessary treatment for my child. (Type full name and date below).
Submit
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