2023 SANP Ticket Form & Waivers

MVHS Senior All Night Party - 2023

Student Behavior Agreement
This Waiver and Behavior Agreement is required for each Monta Vista senior to participate in the 2023 Senior All Night Party. This parent-chaperoned, fun-packed event planned by the Monta Vista High School Senior All Night Party committee will be held at Boomers in Modesto. Ticket price includes food, drink, activities, rides, games, and bus transportation to Boomers. (Seniors will be transported by bus to Boomers from Monta Vista High School. Bus departs MVHS June 9th at 9pm and return to MVHS will be approximately 5:30am on June 10th.)

Seniors - Please READ and Sign below: By signing this document, I understand that attending the 2023 Senior All Night Party is a privilege and I agree to the following:
1. I will follow all state and local Covid-19 requirements including social distancing and wearing my mask throughout the night.
2. I understand that party hours start at 11:00 PM, June 9th, 2023 and end at 4:00 AM, June 10th, 2023.
3. No student who is under the influence of alcohol or drugs will be admitted to Boomers. If I am suspected to be under the influence of alcohol or drugs and am involved in a disruption or in any way represent a danger to myself or others, I will be removed from the premises (no refund) and be subject to any other appropriate action if deemed necessary.
4. Parent/Adult volunteers are present at Boomers for my safety and well-being, and I will respectfully comply with their direction.
5. I will respect and cause no damage to the facility, activities, or other elements of the 2023 Senior All Night Party.
6. I will show respect for my fellow students, as well as the volunteers, by not using inappropriate language.
7. I will refrain from public displays of affection which might embarrass other students or adults.
8. I agree to follow the school rules as specified in the Monta Vista High School Parent and Student Handbook.
9. I understand that bus transportation will be provided to and from Boomers and that Monta Vista High School will be the pick-up/drop-off location. I will not be allowed to drive myself.
I have read, understood, and signed the attached waiver of liability.
Student Signature*

Clear
Student Name*

First NameLast Name
Date*

MonthDayYear
Date
PARENTS: Please sign that you will ensure your student will not be driving and will have a ride to/from Monta Vista High School.

Please notify us in advance if your student needs any special accommodations to participate in this event so that the MVHS SANP Committee can take every effort to make the necessary arrangements that may be required.

Financial assistance is available in a limited amount if needed. All such requests are kept confidential.

For information contact:
Vidya Sinha or Kathy Jacques
info@mvsanp.org
https://mvsanp.weebly.com/
Parent/Guardian Signature*

Clear
Parent/Guardian Name*

First NameLast Name
Date*

MonthDayYear
Date

MVHS Senior All Night Party

Liability Waiver & Covid Acknowledgement
The undersigned assume all risks in connection with the participation of all individuals listed below in any and all of the Monta Vista High School Senior All Night Party (MVHS SANP) sponsored activities. I attest and verify that all individuals listed below are physically fit and able to participate in any MVHS SANP sponsored activities. Further I acknowledge that is it my responsibility to understand any inherent risks associated with MVHS SANP sponsored activities and communicate those risks to all individuals named above. I do hereby certify that to the best of my knowledge and belief all individuals named above are in good health. If I, or other authorized emergency contact, cannot be reached in an emergency, I hereby give permission to secure proper treatment for my child(ren). I/we do hereby consent to whatever x-ray, examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care are considered necessary in the best judgment of the attending physician, surgeon or dentist and performed by or under the supervision of the medical staff of the hospital or facility furnishing medical or dental services. It is further understood that the undersigned will assume full responsibility for any such action, including payment of costs.

I/we release and forever discharge and hold harmless Monta Vista High School Senior All Night Party and all officers, directors, employees, agents and volunteers of the organizations, acting officially or otherwise, from any and all claims, demands, actions or causes of action which in any way arise from the participation of any individuals listed above in any MVHS Senior All Night Party sponsored activities including to and from the event on behalf of myself, my child/children, my heirs, executors and administrators. By signing below, I confirm that I have carefully read and fully understand its contents. I am aware that this is a release of liability and signed it of my own free will.

COVID Waiver and Acknowledgement

I acknowledge the contagious nature of the COVID-19 virus and acknowledge that Monta Vista High School Senior All Night Party and Boomer's in Modesto adheres to the CDC recommendations of practicing social distancing and wearing face coverings.

I further acknowledge that no guarantee exists regarding whether or not I may contract COVID-19. I understand that the risk of becoming exposed to and/or infected by the COVID-19 virus may result from the actions, omissions, or negligence of myself and others, including but not limited to, paid staff, volunteers and others.

I acknowledge that I may increase my risk of exposure to COVID-19 by participating in Senior All Night Party.

In the event a participant tests positive for COVID-19 within Forty-Eight (48) hours of the activity, I hereby waive confidentiality and authorize MVHS SANP to disclose the participation list to the local public health authorities for the purpose of contact tracing.
Please list any allergies, medicine reactions, or medical/physical conditions which should be made known to a treating physician or emergency responder. If none, please write "None".*
Student Signature*

Clear
Student Name*

First NameLast Name
Date*

MonthDayYear
Date
Parent/Guardian Signature*

Clear
Parent/Guardian Name*

First NameLast Name
Date*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.

MVHS Senior All Night Party

Contact Information - please be sure to provide accurate Emergency Contact Information
Student Name*

First NameLast Name
Student Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
MVHS Student ID #*
Student email (optional)
example@example.com
Will Student be 18 or older by June 9, 2023?*

YesNo
Parent Contact Information*

First NameLast Name
Cell Phone*
Please enter a valid phone number.
Email*
example@example.com
EMERGENCY CONTACT INFORMATION
Please provide information where you or another authorized adult may be reached on the night of the event.
Primary Emergency Contact Information:*

First NameLast Name
Cell Phone *
Please enter a valid phone number.
Relationship:*
Secondary Emergency Contact Information:*

First NameLast Name
Cell Phone *
Please enter a valid phone number.
Relationship:*

MVHS Senior All Night Party

Event Information & Ticket Purchase Form
Where: Boomer's in Modesto, from 11pm to 4am

When: June 9, 2023 to June 10, 2023

Bus Pick-up at Monta Vista: 9:00pm on June 9, 2023

Bus Drop-off at Monta Vista: approx. 5:30 am on June 10, 2023

Ticket price includes bus transportation to and from Monta Vista High School, entry to Boomer's, food, drink, games, and entertainment.

Ticket price will increase closer to date of event, so buy your ticket early! You must pre-purchase ticket and submit a fully completed and signed waiver form to attend.
List the name of a friend you would like to sit with on the bus. (Seating preferences are not guaranteed, but we will do our best to accommodate.)
**ALL SALES ARE NON-REFUNDABLE unless Covid Guidelines prohibit event**

Please note that ticket purchases are NOT tax-deductible, but donations made to MVHS SANP, a 501(c)3 non-profit organization, are tax-deductible. Please verify with your tax advisor or accountant. (EIN#20-0507857)
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Grad Night Party ticket
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Please consider donating to help sponsor another studentIncrease quantity to increase donation amount. MVHS SANP is a 501(c)3 non-profit organization. Corporate Matches also welcome! (EIN# 20-0507857)
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MVHS Senior All Night Party - 2023

MVHS Senior All Night Party

MVHS Senior All Night Party

MVHS Senior All Night Party