Central Dauphin High School Guest Permission Form

Central Dauphin High School Guest Permission Form

Any student who wishes to bring a guest that is not a student of Central Dauphin High School must have this form completed before admission to the dance. The minimum grade level for guests is ninth grade and the maximum age is 20.

Student’s Statement:

I understand the responsibilities, rules and guidelines established by the Central Dauphin School District Code of Conduct when attending school-sponsored events and agree to follow these expectations in order to contribute to a positive experience for all. These expectations include, but are not limited to, appropriate behavior, dress, dancing, no profanity, and no possession and/or use of alcohol, tobacco, illegal drugs or weapons. Students who violate these expectations will be asked to leave and may be referred to law enforcement.

CDHS Student name: ______Signature: ______

Guest’s Name: ______Guest’s Age: ______

Guest’s School: ______(Attach a photocopy of the Guest’s Driver’s License or Photo ID)

Please complete if you are NOT in high school:

1.  Guest’s former high school ______Year of graduation ______

2.  Guest’s former high school’s Phone #______

No refunds will be given.

Guest Parent/Guardian’s Statement for high school students:

I give permission for my son/daughter to attend the above stated function at Central Dauphin High School. I am aware of the responsibilities and expectations for participation in such an event and support Central Dauphin High School’s efforts to secure and maintain a safe and enjoyable experience.

______

Parent/Guardian Signature Date

School Reference for Guest

(Must be completed by the guest’s administrator if the guest is in high school)

The above individual has requested permission to attend a function at Central Dauphin High School. Please verify that he/she is a student in good standing and would contribute to a positive experience at this event. You may call the CDHS office at 703-5360 to further discuss the matter if necessary. This form may be faxed to 717-703-5730.

The above individual is currently enrolled at ______and is known to be a student of sound character and behavior. In my professional opinion, he/she will be respectful of the rules, students, staff, event personnel, and property of the activity hosted by Central Dauphin High School.

______

Administrator’s Name Phone Date

______

Administrator’s Signature

CDHS Office Use Only

CDHS Administrator Approval: Yes No Administrator’s Initials: ______Date______