CELEBRATION GRADUATION 2008 - SENIOR REGISTRATION FORM
Student Name_________________________________________________________
Please fill out form completely; incomplete forms will be returned to the student.
______________________________________ has my permission to attend the PHS Celebration Graduation, June 13-14, 2008.
I understand that my child (and his/her approved guest) must be driven home by an adult not attending Celebration Graduation.
Yes No If selected, he/she has my permission to be hypnotized.
Yes No Photos of my child may be used for future Celebration Graduation promotions and publications.
In case of emergency, contact:
1. Name___________________________________ Relationship to student___________________
Home Phone_____________________________ Cell Phone_____________________________
2. Name___________________________________ Relationship to student___________________
Home Phone_____________________________ Cell Phone_____________________________
___________________________________ ___________________________________
Signature of Student Printed Name of Student
__________________________________ ___________________________________
Signature of Parent or Guardian Printed Name of Parent or Guardian
(Form must be signed by a parent or guardian regardless of the student’s age.)
COMPLETED FORMS MUST BE RETURNED TO SANDY WHITE IN THE
MAIN OFFICE BY MAY 30th
THOSE RETURNED BY MAY 30th
WILL BE ENTERED INTO A DRAWING FOR A VERY SPECIAL PRIZE!
Questions? Contact Amy Feitelson, 9647433/9447653/afeitelson@comcast.net
or Diane Agrodnia-Dorow, 430.8034/969.7705/agrods@aol.com