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MGLVA prom 2024 Guest Permission Slip
All guests of MGLVA students must be under the age of 20. Guests must adhere to school policy regarding school-appropriate attire and conduct. Use of alcohol or other illicit substances will not be tolerated.
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* Indicates required question
Name of MGLA student:
*
Your answer
Name of parent/guardian for MGLVA student:
*
Your answer
Emergency Contact for MGLVA student:
*
Your answer
Which prom will you be attending?
*
Shelby Township May 10th
Grand Rapids May 17th
Name of non-MGLVA guest:
*
Your answer
Age of guest:
*
Your answer
Name of School guest current attends if applicable:
Your answer
Are you currently in good standing at your existing school? (MGLVA will be verifying eligible status at guest school districts).
Yes
No
Clear selection
Emergency Contact for guest (including phone number):
*
Your answer
(Print your name) I, ________________________________, agree to respect and abide by all the school rules, policies, and regulations of Michigan Great Lakes Virtual Academy while I am a guest at the Prom on
*
Your answer
Guest Signature (by typing your name, you agree to follow the rules and policies of MGLVA prom.)
*
Your answer
Parent signature if guest is under the age of 18. By typing your name, you agree that you are giving permission for your child to attend the MGLVA prom 2024 event.
Your answer
Date:
*
MM
/
DD
/
YYYY
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