SOUTH KINGSTOWN HIGH SCHOOL
Senior Prom 2015 GUEST AGREEMENT
TO:
FROM:
Students and guests attending the dance and parents/guardians
SKHS Administration
SKHS Student’s Name:
________________________________
SK Student,
Please give this form to your guest to complete. All information in the “Guest Information” box
along with two signatures must be obtained prior to returning the form when tickets are purchased.
Thank you.
GUEST INFORMATION:
Guest Name:
______________________________________
Address:
______________________________________
City:
______________________________________
Zip:
_________________
Food allergies and/or medical concerns that chaperones should be aware of: _________
_____________________________________________________________________________
Guest’s Parent/guardian name:
______________________________________
Emergency phone number at which the PARENT may be reached during this event:
______________________________________
Guest’s School:______________________________________
The individual listed above is a student in good standing at our school:
__________________________________
_____________________
Signature of Administrator from Guest’s school
Position
_________________
Phone Number
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)
Parent and Guest 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.
______________________________________
Guest’s Signature
________________
Date
______________________________________
Guest’s Parent/Guardian’s Signature
________________
Date