BRIAR WOODS HIGH SCHOOL
Prom Dance - April 10, 2015 - 8:00-11:00 PM
Ticket #
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DANCE PERMISSION FORM
This form must be completed before a Prom Dance ticket may be purchased for yourself OR a Guest.
BRIAR WOODS STUDENTS: If you will not be present at school or if you need an early dismissal for 12:00 noon on April
10th you must fill out the attached attendance permission section. If you do not fill out the attendance permission
section and submit it to Mrs. Peyton at the time you purchase your ticket(s) you will be expected to attend school for the
entire duration of the day. Attendance selections are FINAL. ***Absences due to prom preparation on April 10th 2015
will not count against Senior exam exemption attendance. Dress: This is a formal dance, which means that a dress or a
dressy pantsuit is appropriate for women. Men should also be dressed to impress by wearing dress pants, a collared,
button-down shirt, and a tie that is appropriate. Exemptions to the tie rule may apply for men wearing dress shirts with no
collar.
BWHS Student’s NAME: _________________________________________ Grade: ____________
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All Loudoun County Public School and Briar Woods High School rules apply. There will be NO alcohol or drugs on
any part of the Briar Woods campus or at a Briar Woods school sponsored event.
No admittance after 9:30 pm. Students will enter through the Ballroom Doors only.
There will be no inappropriate dancing. Students will be asked to leave if inappropriate dancing is observed. Only
one warning will be given. If you continue to dance inappropriately after the warning, you will be asked to leave.
Once you are asked to leave, you must leave peacefully or you will be considered trespassing and/or disorderly.
If you leave the NCC prom designated area for any reason, you will not be allowed to re-enter. Once you leave
the building you may not reenter. If you are asked to leave the dance, your ticket price will not be refunded.
Each Briar Woods High School student is permitted one guest from another school. BWHS students are responsible
for the actions of their guests. Please complete the attached GUEST section if you intend to bring a non BWHS
student. Guests who do not attend BWHSchool must present a valid PHOTO ID to gain entrance to the dance.
Prom tickets are NON-REFUNDABLE. ALL SALES ARE FINAL.
WE RESERVE THE RIGHT TO DENY ENTRANCE TO THE DANCE
I have read, understand, and agree to abide by the policies and consequences of the Briar
Woods High School “Midnight Masquerade” Prom 2015 Dance.
BWHS Student Name (print)
Student Signature
Date
BWHS Parent Name (print)
Parent Signature
Date
In order to prepare for the Briar Woods High School “Midnight Masquerade” Prom 2015
Dance, I will… (check one). These are your only choices!
 Not be present on Friday April 10th __________.
 Need an early dismissal at 12:00 noon __________.
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NON BWHS GUEST PERMISSION:
Non BWHS Guest’s NAME: ______________________________________ Grade: ____________
Guest’s Current School: ___________________________________________________
Note: Middle School students are not permitted to attend the dance.
Non- student status: If guest is not attending school, list your guest’s place of employment and phone number.
Work: ______________________________________________ Phone: __________________________
The guest listed above is responsible and of good character. He/She is recommended to attend Briar Woods High
School’s Midnight Masquerade 2015 Prom Dance.
_____________________________________Date: ___________Phone: ___________________
(Guest school principal’s or designee’s signature)