Liability Release
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1PERMISSION FORM/LIABILITY RELEASE
CLEAR CREEK HIGH SCHOOL 2015 AFTER PROM PARTY
Group sponsors: Volunteer Parents & Community Members
Where:
Wild Game 1204 Bergen Pkwy, Evergreen, CO 80439
Date:
Saturday, May 2nd and Sunday, May 3rd, 2015
11:30 pm – 3:00 am
Time:
Cost:
FREE
All Junior and Senior students and their dates are invited to attend the After Prom Party,
even if they do not attend Prom.
All students (including dates who do not attend Clear Creek HS) MUST turn in this form
prior to event. No verbal permission will be accepted.
rd
Students will not be admitted to the After Prom Party after midnight, May 3
.
Students will sign in and sign out of the After Prom Party with time noted.
Students leaving the After Prom Party will NOT BE RE-ADMITTED.
Supervision: Parent volunteers and staff from the high school.
Check-in/Check-out: See above. Students are encouraged, but are not required, to stay the entire time.
Driving after curfew: Students are provided with a signed letter stating that they were attending a school function. The time they
left the After Prom Party is noted on the letter. They are expected to drive to their final destination within a reasonable amount of
time after leaving the District Office.
Inappropriate behavior/intoxication: Parents will be contacted to pick their child up at the District Office if there are any behavior
issues that can’t be handled by the volunteers or staff. In case of intoxication, if the parents cannot be reached, appropriate law
enforcement will be contacted.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
In granting my permission for participation in this event, I agree that my student will follow the rules
established for the After Prom Party and will obey the adult sponsors/personnel responsible for supervision.
I will hold Clear Creek School District RE1, its agents, volunteers and employees harmless and indemnify
them from any claim, cause of action or demand arising out of any form or lack of medical or emergency
treatment, excluding acts of willful misconduct or gross negligence.
The parent/guardian and student by signing below agree to the above rules:
I grant permission for __________________________________to participate in the 2015 CCHS After Prom Party.
Student (Print)____________________________________________________________________________________________
Parent/Guardian(Print)____________________________________________________________________________________
Address_________________________________________________________Phone#______________________________
EMERGENCY CONTACT PHONE# DURING AFTER PROM PARTY__________________________________________
StudentSignature_________________________________________________________Date____________________________
Parent/Guardian Signature_________________________________________________Date____________________________
Please turn in this form to the school office by April 30, 2015.
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