Folsom High School 2022 Sober Grad Night Event
Thursday May 26, 2022  9:00 PM - 3:30 AM
The Block at Lakeside Church 745 Oak Ave Pkwy, Folsom, CA
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Parent Approval and Student Waiver
If student is 18 years of age, the student may fill out the waiver.  Student must provide parent contact information at the end of the waiver.
Please Submit Waiver by 5/15/2022
Student's First Name *
Student's Last Name *
Student's Date of Birth *
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The above student has my permission to participate in the Folsom High School Sober Grad Night Event *
I, as the parent or guardian of the above named student or as the adult student, do hereby, for the student above, myself, my (our) heirs, executors and administrators, remise, release and forever discharge the Folsom High School PTSA of the Folsom/Cordova PTA Council, 3rd PTA District and the California Congress of Parents, Teachers, and Students Inc. (California State PTA), and all PTA officers, employees and agents of each of the foregoing, acting officially otherwise, from any and all claims, demands, actions, or causes of action on account of referred. *
I hereby certify the student above is my *
I hereby certify to the best of my knowledge and belief the above named student is in good health. In case of illness or accident, permission is granted for emergency treatment to be administered. It is further understood that the undersigned will assume full responsibility for any such action, including payment of cost
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I hereby advise that the above named student has the following allergies, medicine reactions or unusual physical condition which should be made known to a treating physician. (If none, please write the word "none”). *
Attendees will need to check-in for the event by 11 PM on May 26,2022. *
Attendees cannot leave the event early unless there are significant extenuating circumstances accompanied by a parent/guardian regardless of age. *
It is STRONGLY recommended that the student be dropped off and picked up from the Sober Grad Night event. Your grad will be very tired when released at 3:30 AM and driving abilities may be impaired. *
Provide name and phone number of Parent/Guardian, regardless if student is 18 years of age.  This will be who we contact in case of an emergency. *
Name of Parent or Guardian *
Phone Number of Parent or Guardian *
I understand that I have a right to print and sign this waiver. By affixing a digital signature below. I acknowledge my intent to sign and be bound by this waiver as if I had physically signed. I have a right to a copy of the document and I will print after signing, if I want to retain a copy. Please print waiver before clicking "Submit" to retain a copy. *
Parent, Guardian or Student (if over 18) Signature *
Signature Date
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First and Last Name of Signee *
Address of Signee *
Submit
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