MALIBU HIGH SCHOOL
HOMECOMING DANCE CONTRACT
In order to ensure that our Homecoming dance is a safe and sober event for all students, we need parents and students to initial
and sign a contract indicating understanding and acceptance of certain regulations. Signing this contract helps the school to
keep our children safe and is therefore required to attend the dance.
STUDENT CONTRACT- By initialing and signing the contract, students are agreeing to the following:
Initial
______ I understand and will abide by the rules provided by my high school and by the SMMUSD Board of Education.
Homecoming is a school activity and as such all school rules apply.
______ I understand that I may not return to the Homecoming Dance once I have left.
______ I will comply with requests of school and event officials.
______ I understand that if I violate any rules or fail to comply with requests of school and event officials, that my parent will be
contacted and I will be held outside of the Homecoming Dance until a parent can pick me up.
______ I understand that if I purchase my ticket at the dance, I must have this waiver form with me and it must be completely
filled out. NO WAIVER FORMS WILL BE AVAILABLE AT THE DANCE.
______ I understand that, pursuant to Santa Monica-Malibu Unified School District, Board Policy 5131.61 and its corresponding
administrative regulation, that any student found under the influence of a controlled substance, including alcohol or in
possession of related paraphernalia, shall be prohibited from participating "in cocurricular activities, extracurricular
school activities, and graduation and senior activities" for a period of four weeks. I further understand that I am
attending a private venue and that all students shall be searched by security prior to entering the dance. Students may
be breathalyzed prior to entering the event, if there is a reasonable suspicion that a student may be intoxicated.
PARENT CONTRACT-By initialing and signing the contract, parents are agreeing to the following:
Initial
______ I will not serve alcoholic beverages before the Homecoming Dance to students attending the dance.
______ I will remind my son or daughter that he or she will not be permitted to leave the Homecoming Dance for any reason.
Once my child leaves the dance, he or she may not return. I will also remind my son or daughter that, once they are
inside the building, students will not be permitted to go to their cars.
______ I understand that no refunds will be given once the ticket is purchased.
______ I understand that my son or daughter may NOT attend this event unless this form is returned when the dance ticket is
purchased. I further understand that a parental signature is required even though the student may be eighteen years
of age, and that guests from other schools must obtain a parental signature as well.
______ I understand that, pursuant to Santa Monica-Malibu Unified School District, Board Policy 5131.61 and its corresponding
administrative regulation, that any student found under the influence of a controlled substance, including alcohol or in
possession of related paraphernalia, shall be prohibited from participating "in cocurricular activities, extracurricular
school activities, and graduation and senior activities" for a period of four weeks. I further understand that I am
attending a private venue and that all students shall be searched by security prior to entering the dance. Students may
be breathalyzed prior to entering the event, if there is a reasonable suspicion that a student may be intoxicated.
______ I understand that if my child is required to leave the Homecoming Dance early, it is my responsibility to pick my student
up from the dance. I also understand that the dance ticket is non-refundable.
______ I will be available by phone during the Homecoming dance in case of emergency. My phone number is
________________________.
Student Name
_________________________________________________________
Please Print
Student Signature________________________________________________________
Parent Signature_________________________________________________________
EMERGENCY CONTACT INFORMATION
Emergency Contact Information: In case of an emergency, please contact one of the following.
YOU MUST PROVIDE TWO CONTACT NUMBERS (in addition to the phone number on the front side)
Student Name___________________________________________ Grade___________
Please Print
Student ID # _____________________________________________
CONTACT #1
Name:______________________________ Relationship:______________________________
Address:_____________________________________________________________________
Home Phone #:____________________________Cellular #:_____________________________
CONTACT #2
Name:______________________________ Relationship:______________________________
Address:_____________________________________________________________________
Home Phone #:____________________________Cellular #:_____________________________