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Prom Guest Form

Central High School
2017 Prom Code of Conduct Form

113 Central High Road
Carrollton, GA 30116
Phone: 770-834-3386 Fax: 770-832-0103

Central High School students AND guests must submit this form with payment by March 24, 2017. To ensure that prom is an event that everyone enjoys, please obey the following rules and regulations. Read and sign the form.

Prom will be held at Newnan Centre on March 25, 2017 from 7 pm to 11 pm.
1.Prom is a Carroll County School System event; therefore, all CCSS policies, procedures, and regulations apply. No student should possess, use, distribute, sell, possess with intent to distribute or sell, be under the influence of alcohol, drugs, including unauthorized prescription drugs, tobacco, and/or any other controlled substance before, during, or after prom. Such activities are strictly prohibited by state law as well as school policy and procedure. Anyone found in violation of this policy may be referred to the authorities and referred for school discipline.

2. Improper behavior, including indecent dancing, may result in expulsion from the prom and referral for school disciplinary action.

3. Students who plan to attend prom must be in good standing at Central High School, specifically:
~Students who are currently placed at GOAL for disciplinary reasons may not attend
~Students who are suspended at the time of prom cannot attend prom.
~Students who have been assigned ISS through the Monday after prom cannot attend prom (to be handled at the discretion of their administrator).
4. All fees are non-refundable. See graduated fee schedule. Juniors and seniors pay prom fees only once.

5. Students are expected to be at school the Friday before prom. Absences due to preparation for prom are not acceptable.

6. All attendees are required to present a picture ID to the staff members at the check-in table upon their arrival to the prom. No student younger than fourteen years of age and a current freshman may attend. No guests 21 or older will be admitted. The administration reserves the right to refuse entry to the prom at their discretion.

7. The CHS student and his/her guest must enter the prom at the same time.

8. Once a student or guest exits the prom, there will be no re-entry. NO EXCEPTIONS.

9. Prom fees are not transferable. Any student who seeks to enter the prom must have his name on the prom list. Any student who is allowed entry without having made previous payment or payment arrangements will have a hold placed on his records and this fee will be collected before the student is allowed to participate in graduation activities.
As a guest of the CHS prom, I agree to obey all rules and regulations set forth by CHS and the CCSS concerning student attendance at extracurricular events.

~~I will attend the CHS prom as a guest of _________ (CHS student), who is a JUNIOR SENIOR. (circle one)
~~I am attending as a CHS JUNIOR SENIOR. (circle one)

Guest (or CHS student) name -- printed _______________ Date of birth: ___________

Guest (or CHS student) signature : __________________ Cell phone #: ___________

Printed parent name : ________________________________
Parent signature: ___________________________________
Parent phone #: ____________________________________

For CHS freshmen or sophomores: I am in grade 9 or 10. (circle one)

For high school students who attend other high schools:
You must have this section completed and signed by a current school administrator, and you must attach a copy of your picture ID (school ID, driver's license, etc.).

Name of high school _______________________ City, state: ______________

I am in grade 9 10 11 12. School phone number: ___________________

~To be completed by the guest's high school administrator:
Is the above-mentioned student currently in good standing? YES NO
Do you recommend this student be permitted to attend our prom? YES NO

HS Administrator name: ___________________ Title: __________________________

HS Administrator signature: ____________________________
You must complete this section and provide a copy of your picture ID (school ID, driver's license, etc.) Your must show your picture ID upon entry to prom.

Legal name: __________________________ Date of birth: ___________

Driver's License Number ________________ State: __________