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Prom Night Agreement Parent and Child - PDF

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Prom Night Agreement Parent and Child - PDF Powered By Docstoc
					                          2011 “A Night Beneath the Mask” Prom Registration
                    Please type or print legibly. All information must be complete.
             Purchaser Information:                                   Guest Information:

Name                                                  Name
____________________________________ccccccc           ____________________________________ccccccc
Last name, First name                                 Last name, First name

Grade ________________                                Grade ________________

Address ___________________________________           Address ___________________________________
ccccccccccStreet                                      ccccccccccStreet

__________________________________________            __________________________________________
City                    State       Zip               City                    State       Zip

Home Phone (______)_______________________            Home Phone (______)_______________________

Emergency Phone (______)___________________           Emergency Phone (______)___________________



I have read the attached rules and information        I have read the attached rules and information
provided and have discussed this information with     provided and have discussed this information with
my child. I am aware of the conditions of the         my child. I am aware of the conditions of the
agreement and hereby give my child permission         agreement and hereby give my child permission
to attend the East Allegheny 2011 Prom.               to attend the East Allegheny 2011 Prom.

___________ My child will attend this dance with      ___________ My child will attend this dance with
            the guest registered in Column B.                     the ticket purchaser registered in
                                                                  Column A.
___________ My Child will not attend this dance
            with a guest.



Name_____________________________________             Name_____________________________________
Please PRINT Parent/Guardian Name                     Please PRINT Parent/Guardian Name

Signature__________________________________           Signature__________________________________
Signature of Parent/Guardian                          Signature of Parent/Guardian




A PARENT/GUARDIAN SIGNATURE IS REQUIRED IN            A PARENT/GUARDIAN SIGNATURE IS REQUIRED IN
ALL CASES, NO MATTER THE AGE OF THE STUDENT           ALL CASES, NO MATTER THE AGE OF THE STUDENT
OR GUEST.                                             OR GUEST.GUEST OF STUDENTS WHO ARE NOT
                                                      CURRENTLY ENROLLED AT EAST ALLEGHENY WILL
                                                      ALSO NEED TO FILL OUT THE BACK OF THIS FORM
                                                      AS WELL.
                         East Allegheny High School GUEST REQUEST FORM
Guests are to complete this form and return it to Mrs. Ekis in order to be eligible to attend the East
Allegheny 2011 Prom. Registration forms, a photocopy of ID with proof of age, and this form must be
presented in order to purchase a ticket to the Prom.

I am requesting permission to attend the East Allegheny Prom “A Night Beneath the Mask” on May 13, 2011. I
realize this event is a school-sponsored function and I agree to abide by all the rules and regulations
established by the East Allegheny School District. This includes, but is not limited to, proper dress, no
smoking, no use of alcoholic beverages, and responsible behavior.

The last day to buy tickets will be April 20, 2011. This form, the Registration Form, and a photocopy of a
valid photo ID with proof of age must be turned in by this date.

Please have your school/employer fax this form to (412)825-4570 in care of Mrs. Ekis.


                     Guest Information                                  East Allegheny Student Info


Name _______________________________________________ Name ______________________________

Address _____________________________________________             Phone (______)____________________

         _____________________________________________ Grade __________

Phone (______)___________________

School/Employer_____________________________________

Date of Birth ___________________      Grade ______________

____________________________________________________
(Parent/Guardian Signature)

CHARACTER REFERENCE:
The above individual attends this school/is employed by said employer and is known to be of sound
character. In my professional opinion, he/she will abide by the established rules and regulations governing
your dance. Our school/employee records indicate that he/she has recorded his/her date of birth
accurately and is eligible to attend all extra-curricular functions at his/her school. If the individual above
was not an East Allegheny graduate, he/she must produce a character letter of reference, ON LETTERHEAD,
from a post-secondary school or employer.

__________________________________________________________________________________________
Administrator or Employer Name (please Print)

__________________________________________________________________________________________
Administrator or Employer Signature

__________________________________________________________________________________________
School/Employer Name

__________________________________________________________________________________________
School/Employer Phone Number

				
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posted:7/27/2011
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Description: Prom Night Agreement Parent and Child document sample