Episcopal High School

Episcopal High School

4650 Bissonnet

Bellaire, Texas 77401

713-512-3400 http:/www.ehshouston.org

HOMECOMING DANCE 2016

October 22, 2016

Guest Request Form

Directions: A student requesting to bring a date who is not an Episcopal High School student must have this form completed and returned to Mrs. Boren at the Attendance Desk of the Trotter Academic Building before the end of the school day on Wednesday, October 19th. This form requires the signature of the principal or administrator of the guest’s school. All guests must be enrolled in high school.

______

Name of EHS Student Grade Date

(please print)

As the parent of the above named Episcopal High School student I find his/her date to be a responsible person,

and I approve him/her as an acceptable guest for this Episcopal High School social event.

______

Parent Signature of EHS Student Date

GUEST INFORMATION (PLEASE PRINT)

NAME ______GRADE_____ AGE_____

ADDRESS______City______

PHONE______(HOME)

______(FATHER’S CELL)

______(MOTHER’S CELL)

SCHOOL CURRENTLY ATTENDING______

As the Principal/Administrator of the school this student attends, I verify that he/she is a student in good standing.

______

Signature of Administrator Title Phone number

***ALL BAGS WILL BE CHECKED AT THE DOOR AND UNIFORM POLICE OFFICERS WILL BE PRESENT TO DEAL WITH ANY ALCOHOL OR DRUG RELATED INCIDENTS***

Episcopal High School reserves the right to administer a Breathalyzer test at a school-related activity to any student or his/her guests. If a guest refuses to take the Breathalyzer test, it will be assumed that the test is positive for alcohol and the School will remove the guest from the activity and will contact the student’s parents.”

Bellaire police will deal with any students who are in possession of alcohol or other drugs, or under its influence, while attending these school-sponsored events. Any action on the part of the Bellaire Police Department may result in your parents being called by the police to pick you up and you receiving a warning. Or your actions may lead to your arrest under the laws governing minors in possession or driving under the influence. It is not our intent to scare you away from homecoming activities, but to encourage good character and responsibility by those who choose to attend.

OFFICE USE ONLY: Approved______Not Approved______