South Kingstown High School
2015 Senior Prom
Friday, June 5th
6:30 – 11:00 PM
LOCATION: Newport Marriott, 25 America’s Cup Ave, Newport, RI
COST: $40 per person (this cost has been subsidized by Class of 2015 fundraising events)
South Kingstown High School Parent and Student Form
I understand that students at school sponsored events are not allowed to be either in possession of or under the influence of alcohol or any
other controlled substance. Students who appear in any way under the influence of drugs or alcohol will be asked to submit to a breathalyzer
test. Students will also be randomly selected to submit to a breathalyzer test. I agree to provide transportation home for my son/daughter if a
representative of South Kingstown High School determines that my son/daughter is in possession of or under the influence of a controlled
substance. Additionally, I understand that my son/daughter will be subject to school and district policy for being under the influence of drugs
or alcohol.
I also agree that no alcoholic beverages will be served to students in my home before the dance and that limousine services used by my
son/daughter will be notified that the patrons are under age and may not consume or be served alcohol or any other controlled substance.
NO GRIND DANCING – Students engaging in this type of activity will be removed from the
dance and parent/guardian will be called to pick up student from the event. Students can lose the
privilege of attending future dances.
Doors open at 6:30 PM. All guests MUST be checked in by 7:00 PM.
Earliest departure will be 10:30 PM. Students who choose to leave before the conclusion of the dance will not be permitted to return.
NO REFUNDS after the last day of ticket sales.
ALL SCHOOL RULES APPLY.
Food allergies and/or medical concerns that chaperones should be aware of: __________________________
_____________________________________________________________________________________________
_____________________________
Parent’s printed name
__________________________
Parent’s signature
________________
date
_____________________________
Student’s printed name
__________________________
Student’s signature
________________
date
**EMERGENCY Phone number at which the PARENT may be
reached during this event:_(
)
-_______________
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senior prom permission ship skhs student