RSVP/Waiver form

Malibu High School
Class of 2015 Grad Night Party
June 4, 2015
RSVP • Waiver of Liability • Code of Conduct
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No Senior will be admitted without signed RSVP - Waiver of Liability - Code of Conduct (see back)
Must be signed by both a parent and the senior.
Cost: $125 per Senior
Scholarships are available. Please contact Phil Wenker at pwenker@smmusd.org to request one.
Parent
By my signature on the back, I authorize my son/daughter to participate in the MHS 2015 Grad Night Party
and RSVP on his/her behalf, and agree to all terms listed below.
Senior
By my signature on the back, I agree to all terms listed below.
I hereby release and forever discharge, indemnify, and hold harmless Malibu High School, the Santa MonicaMalibu Unified School District, the Malibu High School PTSA, The Malibu High School Class of 2015 Grad Night
Committee, the Avalon Hollywood/Bardot Hollywood, and all their respective board members, officers,
employees, agents and volunteers from any and all claims and liability that may arise from or in connection to
my student's participation in the Malibu High School Grad Night 2015. The aforementioned parties are not
responsible for lost or stolen items.
Permission is hereby granted for emergency medical treatment to be administered in the case of any injury,
accident and/or illness during this event. I understand and assume full responsibility for any such action,
including payment of medical costs.
It is understood the possession or consumption of alcohol or drugs, behavior under the influence, leaving and
then re-entering the event site(s), and smoking are PROHIBITED at this event. Absolutely NO liquid, bottles or
drinks of any kind will be permitted onto the buses. Only small purses will be allowed. All bags will be
searched.
This event is for Malibu High School graduating senior students only. Only Malibu High School students who
board the buses from Malibu High School will be permitted to participate in the Grad Night 2015 celebration.
Absolutely no private or other transportation will be permitted for students to the event location(s) nor back
to Malibu, and no one is permitted to leave the event at any time before the buses return to Malibu at the
end of the event.
Parents are required to drop off their senior at 8:00 p.m. at Malibu High School upper Senior parking lot so
their child may board the bus. They must pick up their senior at 4:00 a.m. in the Casa Escobar Malibu parking
lot located at 22969 Pacific Coast Highway . NO GRAD NIGHT PARKING WILL BE PERMITTED AT MHS.
Any student violating this Code of Conduct must be picked up by a parent immediately at the Grad Night
venue in Hollywood.
RSVP - Waiver of Liability - Code of Conduct
Please sign and return this form in the envelope provided, along with a check for $125 payable to MHS GRAD
NIGHT by Monday, May 11, 2015. Tickets can also be purchased online at the MHS Store but the RSVP must
be mailed in.
Some students need scholarships in order to attend this event. Please consider adding $10, $25, $50 or more
for our Scholarship Fund (we want ALL Seniors to be able to attend this 2015 Grad Night Celebration).
Tickets must be purchased in advance and are non-refundable.
Please check one:
_____ Enclosed is a check in the amount of $ __________.
_____ This is my child's RSVP. I am purchasing my child’s ticket online or at the MHS Student Store.
_____ This is my child's RSVP. I am requesting a scholarship and will be contacting Phil Wenker.
Print Student Name:
Student Signature:
Date:
By my signature above, I agree to all terms listed above
Print Parent Name:
Parent Signature:
Date:
By my signature above, I agree to all terms listed above
Please provide numbers where parent(s) can be reached on Thursday, June 4 between 8:00 p.m. to
4:00 a.m. You will be called to pick up your child if he/she violates the Code of Conduct.
Phone 1:
Phone 2:
Emergency Contact (if I can’t be reached at numbers above):
Relationship to Senior:
Phone:
The following are health conditions relevant to my child at this event:
Thank you for helping to make this a Safe and Sober, fun and celebratory evening for our 2015 Seniors!