Salesian Shadow Program

I AM Salesian! The Salesian Shadow Program offers 8th grade and transfer students an opportunity to shadow our current high school students to learn more and experience a day in the life of a Salesian student. If your school is not already visiting Salesian College Prep for an 8th Grade School visit, your student can schedule a Shadow Visit. Students will tour our campus, visit multiple classrooms, enjoy a complimentary lunch and meet our faculty and students.

The day begins at 9 am and ends at 11:30am.

Emergency Medical Form for Shadow Program

Please fill and submit the following forms before registering for a shadow visit.
For questions, contact Rebecca Mangle, Admissions & Registrar Coordinator at rmangle@salesian.com, or (510) 234-4433 ext. 1001.

Emergency Medical Information Form

Emergency Medical Information Form

Required

Salesian College Preparatory

Emergency Medical Information Form

Student Namerequired

First Name

Middle (optional)

Last Name

Student Date of Birthrequired

Must contain a date in M/D/YYYY format

Parent/Guardian Namerequired

First Name

Middle (optional)

Last Name

Cell Phone #required

Home Phone #

Work Phone #

Emergency Contact other than parent or guardianrequired

First Name

Last Name

Cell Phone #required

Work Phone #

Name of Insurance Companyrequired

List any special conditions such as allergies, illnesses, medications or pertinent medical historyrequired

List any medications the student is currently takingrequired

I, the undersigned, as parent/legal guardian of the named student, a minor, do hereby authorize a representative of Salesian College Preparatory as agent for the undersigned to consent to any medical or surgical diagnosis or treatment and hospital care deemed advisable by, and is to be rendered under the general or special supervision of any physician and surgeon licensed under the provisions of the California Medicine Practice Act on the medical staff of an accredited hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. It is understood that this authorization is given in advance of any specific diagnosis treatment or hospital care being required but is given to provide authority and power on the part of Salesian College Preparatory to give specific consent to any and all such diagnosis, treatment or hospital care that the above mentioned physician in the exercise of his or her best judgment may deem advisable.

E- Signature of Parent/Guardianrequired

Daterequired

Must contain a date in M/D/YYYY format

Register for a Shadow Visit by clicking the button below. You will be redirected to SchoolAdmin to complete registration.

In This Section

Salesian Shadow Program

Emergency Medical Form for Shadow Program

Emergency Medical Information Form

Salesian College Preparatory

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