Form 2‐ Non‐ Las Lomas Student Guest Pass

Form 2‐ Non‐ Las Lomas Student Guest Pass
FORM 2: Non­Las Lomas Student Guest Pass ($85) Jr. Prom 3/21/15, Diablo Country Club
Las Lomas High School
1460 South Main Street ­ Walnut Creek, CA 94596 P: (925) 280­3920 F: (925) 280­3921
Use ink to complete this form.
Please plan accordingly! This form must be signed by the Guestʼs school administrator before itʼs approved by the Las Lomas Attendance Office – this takes advance planning.
• At least two days PRIOR TO ticket purchase dates (TBD), submit this completed form to the Attendance Office (to receive permission to purchase a guest ticket at the time Prom ticket is purchased).
• Permission/approval is granted one day after the form is turned in to the Attendance Office – student must check with Attendance Office to
learn of approval and to receive an official permission slip for their guest. NOTE: The official permission slip is required at Ticket Purchase.
• Any illegible or altered Guest Pass (including erasures and white out) will not be accepted. Each Guest Pass is verified for accuracy. Any forged signatures may result in forfeiture of Prom attendance by Las Lomas Junior and guest, and LL student may be suspended.
• Students must enter and leave the Prom with their guest. Limit of one Guest Pass per Las Lomas Junior.
• No middle school student guests allowed.
• Guests older than high school age subject to approval by Las Lomas administration.
• Guests must show driver’s license or photo ID at time of Prom check in.
• Las Lomas student is responsible for informing guest of all LLHS behavior and dress code rules.
PLEASE PRINT
Name of Las Lomas Student: Name of Guest:
Guest’s Home Phone: Guest’s address:_ Guest is in grade
at
in (school name)
(city)
Note: If guest does not attend high school, you must attach a legible copy of guest’s valid driver’s license or state ID card.
Guest’s Medical Insurance Carrier: Medical ID #: Guest’s Adult Emergency Contact available during Prom:
Name: Phone: Relationship to guest: To Be Completed by Administrator of Guest’s School:
“I acknowledge the guest has an acceptable behavior, attendance, and academic record and is eligible to attend dances at our school and is therefore eligible for the LLHS Prom.”
Administrator’s Signature
Date
ATTACH BUSINESS CARD
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
To Be Completed by Guest/Parent
“I will abide by all of the Las Lomas High School rules and regulations. I understand that I will not receive a refund if I am asked to leave.”
Guest’s Signature
Date Parent of Guest: “I understand that my child must abide by all LLHS rules. Poor behavior may result in consequences for the LLHS student as well as my child, such as reporting the behavior to his/her school and denying attendance to future LLHS functions.
Parent of Guest’s Signature: Date To Be Completed by Las Lomas Student’s Parent
“I understand that my child will be taking a non­LL guest to the Junior Prom and that a guest’s poor behavior can result in consequences for my child.”
LL Parent Signature:_
Date