Last name initial: _______
Souderton Area High School Dance Permission Form
Form must be completed to purchase a ticket.
Name of Dance: _____________________________________________________
Date of Dance: _____________________________________________________
Cost of Tickets: _____________
Student Name:
Student Grade:
Student ID #:
Form of Payment: Check or Cash Check Number___________________________
Parent name:
o Money and permission slips must be submitted by the Tuesday prior to the Senior Prom
o Money and permission slips must be submitted by the Wednesday prior to the Homecoming Dance, Winter Ball, and Junior
School Attendance
o Participation in a school-sponsored activity requires that the student must be in attendance at school on the day of the
activity. To be considered in attendance, the student must be in school at least three entire instructional blocks. The student
must arrive at school no later than the start of 2nd block to fulfill this attendance requirement. An unexcused tardiness, even
when the student arrives prior to the start of 2nd block, could declare a participant ineligible and prevent him/her from
participating in a co-curricular activity
o Students receiving homebound instruction are not eligible to attend dances/proms
o This permission form must be returned when the ticket is purchased for a guest to attend the dance
o Every person who is not a SAHS student is considered a guest and must be accompanied by a currently enrolled SAHS student
o SAHS students are limited to one guest
o Guest information must be filled out on back of this page
o Souderton Area High School’s Student Council and Student Government sponsor all dances, and all school rules and regulations
apply at these events
o All attendees must remain in proper attire throughout the entire dance. Dresses/skirts must be at least mid-thigh, with no
plunging backs below mid-back, not made from transparent material, nor have side or front cut outs
Please sign below and acknowledge that you have read and understand the dance expectations:
Student signature:
Parent/Guardian signature:
GUEST INFORMATION: Please complete this section if you are bringing a guest to the dance.
All guests must be under the age of 21 and in at least 9
Every person who is not a Souderton Area High School student is considered a guest and must be accompanied
to the dance by a currently enrolled Souderton Area High School Student. A Souderton Area High School
student may only bring one guest to the dance
Dance Guidelines on front page apply to all persons attending the dance, including guests
Guest Name: _____________________________________________
School Currently Attending:
Guest’s Address:
Guest’s Home Telephone #:
Guest’s Parent/Guardian Name:
Guest’s Parent/Guardian Signature: