Off-Campus Lunch Permission Form

Off-Campus Lunch Permission Form - Summer Only

*Only for those who are 14 or older - and licensed drivers only*
Campus Policy on Leaving Premises:
- Proximity to Restaurants:
  There are no restaurants directly adjacent to the premises. [Map]
- Policy for Kids under 14:
  Anyone under 14 can only leave with an older sibling or request to have an older teen or licensed driver pick something up for them.
- Policy for Kids 14 and Older:
  Anyone 14 and older may walk in groups of 3 or more to these nearby restaurants:
  (Cloveberry, Subway, Asian Island, Burger King, and Cafe Pierrot only).
  * For safety and insurance reasons, walking alone is NOT permitted.
  If you are found walking alone, permission to leave will be revoked.
  
  Policy for Leaving Campus:
- Licensed drivers only may leave campus (in their car) for these approved restaurants: Tokyo Sushi, Anthony Francos, Sparta Diner, Dunkin Donuts, Frank's Pizza, Sushi Ya, Boneyard, Lake House, Casa Mia, St. Moritz, Kroghs, and Il Porto.
- This Permission to Leave Campus form MUST be signed by a parent is mandatory for licensed drivers.
- For insurance compliance, only siblings of licensed drivers may accompany their licensed sibling off-campus.
Child's Name*

First NameLast Name
Age*
Date of Birth*

MonthDayYear
Date
SUMMER INTENSIVES ONLY - SELECT THE ONE YOUR CHILD IS DOING*

2026 TBA2026 TBA2026 TBA
Parent/Legal Guardian Name*

First NameLast Name
Relationship to the Minor*
Phone Number 1*

Area CodePhone Number
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does this child have a valid NJ/NY driver's license?*

YESNOPERMIT (not allowed)
If the licensed child has any siblings attending who will be leaving with them for lunch, please list their names below.*
If there are no siblings, please list any close friends you approve to leave with. ** By listing non-siblings, you acknowledge and accept responsibility for any incidents or accidents that may occur.
Please check all if you agree (without agreeing to all, student may NOT leave campus):*

Only licensed drivers may go out for lunch.Student may not venture out beyond a 5 mile radius of the RSYTC CAMPUS.Students who leave for lunch must return by 12:30PM or within a half hour of when lunch starts. If excessive lateness occurs, RSYTC can void permission to leave campus for the duration of the camp.**RSYTC staff will NOT monitor students when students leave campus for lunch.
Please check all (without agreeing to all, student may NOT leave campus):*

I understand that my child is responsible for her/his actions and behavior at all times.I understand that my child will not be monitored by staff during out-lunch.I understand and agree that Rising Stars Youth Theatre Co. (including its staff) will not be held liable for any legal issues, expenses, damages, or injuries arising from my child's behavior outside of campus, including transportation to or from restaurants and activities at or in restaurants, during lunch breaks within program hours.Additionally, I acknowledge that Rising Stars Youth Theatre Co. (and its staff) shall not be held liable for any car accidents, damages, or other incidents that occur when a licensed driver leaves the campus premises.
I, {parentlegalGuardian}, the parent or legal guardian of {childsName}, give RSYTC my permission to allow said child to leave the premises for lunch, as stated in this form.

* I {parentlegalGuardian} will not hold RSYTC or any of its staff and/or agents, liable in any way for the risk, danger, injury, or damages caused.
Parent's Signature*

Clear
Date Signed*

MonthDayYear
Date
Should be Empty:

Off-Campus Lunch Permission Form - Summer Only