Shadow Program Registration Form

  = Required Information


Your registration will not be submitted if there is missing or incomplete information.

Family Information

Address Information

Contact Information

Desired Shadow Program date.

Participant Information

School Information

Release Statements

I, on my own behalf as the Participant or on the Participant’s behalf as parent or legal guardian of the Participant, acknowledge that Participant’s participation in the Program(s) is voluntary, is not a condition of Participant’s employment and Participant is not “at work” or acting as an employee of The Center for Aquatic Sciences at Adventure Aquarium by participating in the Program.
Photo Consent:
I consent to the taking of and use for promotional/programmatic purposes by the Center, Adventure Aquarium or their designates of my child's name, image, and likeness, as shown in photographs, social media, motion picture film and/or electronic images, and/or audio recordings made of my child's voice during the program. I understand if I consent that such materials shall be the sole property of the Center for Aquatic Sciences at Adventure Aquarium and there will be no remuneration received by me or my child.
Medical Consent:
If my child needs emergency medical care and no one can be contacted, I give my consent for the transportation of my child by ambulance and for the administration of any treatment deemed necessary by licensed medical personnel.
If my child uses an epi-pen, I give permission for Center staff to administer the epi-pen in the case of an emergency
My child will be participating in the High School Shadow Program operated by the Center for Aquatic Sciences at Adventure Aquarium.
I do hereby waive and release the Center, and its Trustees, officers, employees, agents and contractors, of any and all liability (including attorney fees and costs) arising out of or in connection with my child's participation in the Program. I agree to assume financial responsibility for all medical and hospital expenses.
I/We have carefully read the High School Shadow Program Release statements and fully understand its contents.(Please Electronically Sign and Date Below)
5/16/2021 ]

Payment and Refund Acknowledgement

Payment is due in full upon reservation.
If you need to reschedule, please contact us at least 2 weeks prior to the program date.
Cancellations received less than 2 weeks in advance will receive a 50% refund.
You can pay your reservation online or make checks payable to “The Center for Aquatic Sciences”.

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