Las Lomas High School
1460 South Main Street, Walnut Creek, CA 94596 (Fax) 925-280-3921
Form 3: APPLICATION FOR SENIOR BALL GUEST PASS
Class of 2014 Senior Ball May 17, 2014
Students bringing guests to a Las Lomas High School dance must abide by the following regulations:
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Use ink to complete this form. Submit this completed form to the Attendance Office by Tuesday April 29 to
receive permission to purchase a guest ticket at ticket sales or on the Webstore.
Any illegible or altered Guest Pass (including erasures and white out) will not be accepted. Students must enter and
leave the Ball with their guest. The Ball begins at 8:00PM (DOORS CLOSE AT 9:00) and ends at 11:30PM. No student
will be able to leave the Ball until after 11:00PM.
Limit of one Guest Pass per Las Lomas Senior.
No middle school student guests allowed.
Guests older than high school age subject to approval by Las Lomas administration.
Guests must show driver’s license or photo ID at time of Ball check in.
Las Lomas student is responsible for informing guest of all LLHS behavior and dress code rules.
Each Guest Pass is verified for accuracy. Any forged signatures may result in forfeiture of Ball attendance by Las
Lomas Senior and guest, and LL student may be suspended.
PLEASE PRINT
Name of Las Lomas Student:
Name of GUEST:
Address of Guest:
Home Phone Number of Guest:
Guest attends
School in
Guest is in
grade. OR
Guest does not attend school.
Note: If guest does not attend high school, you must attach a legible copy of guest’s valid driver’s license or state ID card.
Guest’s Adult Emergency Contact (available May 17):
Name:
Phone:
To Be Completed by Administrator of Guest’s School:
“I acknowledge the guest has an acceptable behavior, attendance, and academic record and is eligible to attend
dances at our school and is therefore eligible for the LLHS Senior Ball.”
Administrator’s Signature
Date
To Be Completed by Guest/Parent
“I will abide by all of the Las Lomas High School rules and regulations.”
Guest’s Signature__________________________________________ Date _____________________
Parent of Guest: “I understand that my child must abide by all LLHS rules. Poor behavior may result in
consequences for the LLHS student as well as my child, such as reporting the behavior to his/her school and
denying attendance to future LLHS functions. I understand that that the Ball runs from 8:00PM (DOORS CLOSE
AT 9:00PM) TO 11:30 PM and that no student will be able to leave the Senior Ball b e f o r e 1 1 : 0 0 P M . ”
Parent of Guest’s Signature _______________________________________ Date ______________________
To Be Completed by Las Lomas Student’s Parent
“I understand that my child will be taking a non-LL guest to the Senior Ball and that a guest’s poor behavior can
result in consequences for my child.”
LL Parent Signature __________________________________________
Date _______________________