Cawthra Park Secondary School
2015 Graduation Prom Ticket Purchase Information
Tuesday, June 23th, 2015, 5:30 - 11:00 pm
Mississauga Convention Centre
Cawthra Student Information:
Name: ____________________________ Student # _______________
Cash______
or
Ticket # _______
Cheque________
Meal Choice (Meat or Vegetarian) _____________________________
Table # ______
Food Allergies: _____________________________________________
Expectations:
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Attendance of students and guests are upon approval of Administration.
Students must complete the ticket purchase form, including parent signatures. The ticket is non-transferable and nonrefundable.
There are no in-and-out privileges.
Guest and student tickets must be purchased and paid for at the same time.
Tickets cannot be purchased for guests until the guest has been approved by an administrator. Bring the completed
guest contract to the Main Office, with a photocopy of the guest’s student identification. There is a one day turnaround time to pick up your signed approval for your guest. One guest per student.
You and your guest will both be required to leave if there is any issue of concern with either you or your
guest.
Each Cawthra student is responsible for their guest. Therefore, seating arrangements MUST place the student and
his/her guest at the same table. The guest must arrive with the Cawthra student.
Students must arrange transportation from the event for 11 pm.
 The Prom is a ZERO tolerance event – police will be involved for drinking or drug violations. Any student or
guest, upon arrival, suspected of consuming alcohol or drugs prior to the prom will have their parents called
and will not be admitted. There will be no refund for the ticket.
 Parents must be available for contact, in case of emergency or disciplinary action.
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When you submit this application you are agreeing to abide to the rules set out in this document and at
the Grad Meeting, held on May 23rd. Failure to abide by the expectations will result in disciplinary
action, including not being admitted, or removal from prom.
_________________________________________________________________________________________________________________________
I am aware of whom my son/daughter is bringing as a guest, if applicable, and I acknowledge and agree to the terms and conditions of my
son's/daughter’s attendance at the Graduation Prom.
Parent Signature: ___________________________________________(required):
Parent Day Time Telephone Numbers:
____________________________________________________________
Parent Evening Telephone Numbers: _____________________________________________________________
As a school event I agree to follow all school code of conduct expectations. If I am bringing a guest, I acknowledge that I will
be responsible for my guest as per the expectations above.
Student Signature:
______________________________________
Date: __________________________________
By providing the personal information requested above, I consent to the collection, retention, use and disclosure of this personal information by the School and the Peel District School Board, its
employees and volunteers. I acknowledge that this information will be retained for at least one year. Personal information on this form is collected under authority of the Education Act,
Regulation 298 s.11(3)(f) and in accordance with the Municipal Freedom of Information and Protection of Privacy Act and will be used for the purpose of determining eligibility to attend the
Cawthra Park Secondary School Graduation Prom and for the purpose of providing emergency services, including emergency medical service. Questions about this collection should be directed
to the Principal of Cawthra Park Secondary School.
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Cawthra Park Secondary School
2015 Graduation Prom Ticket Purchase Information
Guest Application
PCSS Administrator’s
CPSS Administrator Approval of Guest: ___________________________ Date: _____________________
Tickets cannot be purchased until the application has been approved by a Cawthra Administrator.
Cawthra Student’s Name ____________________ Student #_____________________
Guest Information:
Name:
___________________________________________________
Meal Choice (Meat or Vegetarian)
______________________________ Allergies:_________________
Home address ___________________________________________________
Contact numbers: Cell: ___________________
Home: _______________________
Date of birth DD-MM-YYYY: ______________________________________
Guest’s School: __________________________________________________
I agree to:
 Provide a photocopy of photo identification (student school ID, driver's license, passport, etc.) and
submit the photo id with this form;
 Respect all those in attendance, and follow the instructions of any supervising adult;
 Not consume or possess any alcohol or illegal drugs;
 Identify myself (with photo identification) to the supervising adults at the beginning of the event;
 Leave the event immediately if directed to do so by a supervising adult.
Guest signature: _________________________________
Date: _____________________
To be completed by guest's parent or guardian (if guest is less than 18 years old):
I have read all of the conditions/rules on this form and give permission for my son or daughter to attend the
Cawthra Park Secondary School's Prom on June 23, 2015.
Parent/Guardian signature:
__________________________
Date: _____________________
Cell phone No.
__________________________
Home No. __________________
To be completed by Principal or Vice-Principal of the guest's school (if a Secondary School):
_____ I recommend that this student be allowed to attend the Cawthra Park SS Prom, 2015.
_____ I do not recommend that this student be allowed to attend the Cawthra Park SS Prom, 2015.
Principal/Vice Principal's name:
______________________________________
Principal/Vice Principal's signature: ______________________________________
Principal/Vice Principal's contact number: __________________________________
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