All Ticket Purchasers Must Complete This Form

Table #______

ALL TICKET PURCHASERS MUST COMPLETE THIS FORM PROM 2017 -- -- DOCUMENT OF UNDERSTANDING No Individual 21 years of age or older is allowed at prom With our signatures, we acknowledge that we have read and agree to the following statements. We understand that all EPCHS behavior expectations are in effect during the PROM, and disciplinary measures will be taken for violation of school rules. Noncompliance constitutes ineligibility to attend prom. There will be no exceptions.

1. Appropriate behavior is required. Prom is a formal occasion, and students are expected to behave accordingly. Prom attire must be appropriate for a high school dance (See number 9 below). They are expected to comply with directions of chaperones and security personnel. Prom is located at Chateau Del Mar, 8301 W 95th St, Hickory Hills.

2. Students are expected to arrive NO LATER THAN 7:45 p.m. for prom, the doors will lock at this time and no one is permitted in after 7:45. Parents/guardians will be contacted if a student does not arrive at prom by 7:45 p.m. in order to determine student safety.

3. All students attending prom must be in attendance the full scheduled school day on the day of the prom or they will not be allowed to attend prom.

4. Students must be in good standing with the Attendance Office, the Business Office, all school organizations, the LRC, the Main Office, i.e., not on loss of privilege, have no unserved detentions, overdue books or fines, or MONEY OWED.

5. The prom will be a smoke-free school activity in accordance with school board policy. (See the Student-Parent Handbook.) Students or their guests (no matter what age) will be required to leave if caught smoking or in possession of smoking materials. If this is the case, parents/guardians may be required to pick up their student.

6. Any student who is in possession of or has consumed any form of alcohol/drug prior to or during the prom will be sent home. As stated in the Student-Parent Handbook: The school administration is authorized to discipline students for …"Using, possessing, distributing, purchasing, or selling alcoholic beverages. Students who are under the influence of an alcoholic beverage are not permitted to attend…school functions and are treated as though they had alcohol in their possession.” (See the Student-Parent Handbook) If school personnel find reasonable cause to believe a student is under the influence of drugs, alcohol, or other prohibited substances, the student will be turned over to the police department.

7. Students will not be readmitted to prom once they leave.

8. The cost of the prom ticket will not be refunded for any reason.

9. Appropriate attire: Gentlemen=tuxedo, suit Ladies=modest dress-no bare midriffs For your information there is a PowerPoint presentation on the EPCHS website pertaining to appropriate prom wear.

Please fill out the form below. If guest is not an EP student and attends another high school, a guest pass must be filled out along with this document. By signing I agree to abide by the above statements.

______Print Student's Name (Person Paying for tickets) Year in School Student's Signature

______Signature of Parent/Guardian Phone Number Where Parent/Guardian Can Be Contacted During Prom ------

______Print Guest's Name Guest’s High School Guest's Signature

______Guest an EPCHS Student? Yes No* Signature of Guest's Parent/Guardian Phone # Picture ID or Guest Pass? Yes No**

*If guest is not an EP student and is in high school – Fill out Guest Pass and bring that with you to purchase your ticket. **If guest is not in high school a photocopy of their picture ID must be presented when you are purchasing your prom ticket must be under 21. Cash amt______Check #/amt______

List any Dietary Needs Here:______Student Name: ______Student must print name legibly

Evergreen Park Community High School Fees Paid/Academic Requirement Sign-off Date: ______Signature: ______Terra Button* *Mrs. Fullarton’s signature indicates that all fees are paid and a prom ticket can be purchased. Evergreen Park Community High School Permission from the LRC to purchase a Prom Ticket Date: ______Signature: ______Tina Ward/ Karen. Hewitt*

*Mrs. Ward or Mrs. Hewitt’s signature indicates that all fees are paid and a prom ticket can be purchased. Evergreen Park Community High School Counselor Sign-off/Academics Date: ______Signature: ______Counselor*

*Counselor’s signature indicates that all academic requirements have been met and a prom ticket can be purchased. Evergreen Park Community High School Rules/Dress Code Acknowledgement Date: ______Signature: ______YOUR signature*

*Your signature indicates that you have seen, read and understand the rules of the prom (including dress code).