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Prom

Request for Prom attendance – guest

To ensure a safe environment, the following guidelines will be in effect:

1. All visitor guidelines will apply.

2. Each attendee is responsible for abiding by the rules of the Prom.

3. Food and beverages will be served. Please refrain from bringing in any food or drink.

4. You are not permitted to bring in any beverage containers.

5. If an attendee appears to be under the influence of alcohol or any other controlled substance, he/she will not be allowed to participate in the Prom and will be asked to leave.

6. All attendees will remain at the Prom until its conclusion at 9:00 p.m. Prom attendees must be picked-up by a licensed driver by 9:00 p.m.

7. By signing this form, you have agreed to have photos taken that may be used for Children’s Wisconsin publications.

All Prom attendees require an adult signature (if under 18 years of age).

Release of liability:

In consideration of my or my child’s participation in this event, to the fullest extent permitted by law, I (and my child if I am signing as parent or guardian) release Children’s Hospital and Health System, Children’s Wisconsin, their officers, directors, employees, volunteers and agents from any liability or claim for injury or illness that I or my child sustain during my or my child’s participation in this event. I understand that there are risks associated with participating in this event, such as the risks of injury while dancing. I understand that this release applies to myself or my child and my or my child’s personal representative, heirs, and assigns. I and my child also waive the right I have to bargain for different release of liability terms.

I have read the guidelines for the prom and consent form. By selecting the YES option below and typing my name, I confirm I am the person named above, I (or my child) will follow the guidelines of this event, I am legally able to consent for myself or my child and I hereby give my consent under the terms stated above.