* Required

Grad Night Party Student Agreement, Parental Consent, and Fee Payment

The Grad Night Party Committee is committed to producing an alcohol and drug free event for the Class of 2020 while keeping all participating graduates safe during the evening. The student listed below wishes to participate in the Grad Night Party and agrees to abide by the rules set forth by the Grad Night Party Committee. Note: A separate form must be completed for each student.

Student's First Namerequired

Student's Last Namerequired

Student Agreement

I have read the GRAD NIGHT PARTY INFORMATION AND GUIDELINES and I understand and agree to abide by the guidelines as provided. I will not bring purses, bags, backpacks, keys, cell phones, cameras, electronics, watches, or money. I understand that they are NOT ALLOWED and will be confiscated until the end of the event.

Digital Student Signature*

Student Signature Indicating Agreement

First and Last Name of Student Signingrequired

Parent/Guardian Consent

I acknowledge that the Grad Night Party is not a Jesuit High School sponsored event. I agree to follow the rules established by the Grad Night Party Committee, which is comprised of Jesuit parents who have volunteered to organize this event.

I have read the GRAD NIGHT PARTY INFORMATION AND GUIDELINES. I understand and agree with its content and hereby grant permission for my son/daughter to participate in the Grad Night Party. I assume all risks associated with my son's/daughter's attendance and participation in this event. I hereby agree to hold Jesuit High School, the vendors associated with this event, the Grad Night Party Committee and each of its members, and any parent volunteers, harmless from any and all liability which may occur in connection with my son's/daughter's participation in this event.

Digital Parent/Guardian Signature*

Parent/Guardian Signature Indicating Agreement

First and Last Name of Parent/Guardian Signingrequired

Does your student have any allergies or other dietary restrictions that we need to accommodate?*

Yes No

Please explainrequired

Parent Permission for Treatment in Event of Medical Emergency and Release from Liability

In the event of a medical emergency, I hereby give permission for my child to be treated and/or transported to the nearest hospital for treatment as is deemed necessary by emergency medical personnel, Jesuit school personnel, or attending physicians. I hereby release Jesuit High School and all persons associated with the Grad Night Party from all liability for any claims, damages, or injuries incurred or suffered by my child resulting from his/her attendance at the Grad Night Party.

Digital Parent/Guardian Signature*

Parent Signature Granting Permission to Treat and Releasing Liability

First and Last Name of Parent/Guardian Signingrequired

Grad Night Party Fee

The Grad Night Party fee is $100. It will cover all costs for a safe and fun evening.

Please choose from the options below:*

By checking this box, I authorize Jesuit to charge my credit card $100 for the Grad Night Party. By checking this box, I would like to request financial assistance.

Please charge my credit card the following amountrequired

Please send a confirmation email to the address below*: