2025 Lassen County Sober Graduation Registration Form
It's time to celebrate your high school graduation. The Lassen County Office of Education would like to invite you to the 39th Annual Lassen County Sober Graduation on Friday, June 6, 2025 from 9:30 p.m. to 2:00 a.m. at Lassen High School, 1110 Main Street, Susanville, CA 96130. This will be a night of fun, food, dancing, activities, prize giveaway, and the Wheels West Grand prize car giveaway that will culminate the evening's events. The event is only for graduates. Guests will not be permitted. No outside food or beverage will be allowed. School dress codes need to be followed. All graduates need to be checked in by 11:00 p.m. Please complete this form to register for the event. If you have any questions, please contact James Hall at 530-251-8711 or by email at jdhall@lcoe.org.
Graduate Name
*
First Name
Last Name
Graduate Email
*
example@example.com
Graduate Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
High School
*
Please Select
Big Valley Jr. Sr. High School
Herlong Jr. Sr. High School
Mt. Lassen Charter
Lassen Union High School
Credence High School
Lassen High Community Day School
Thompson Peak Charter
Long Valley School - Doyle
Westwood Jr./Sr. High School
Lassen Diploma Gold
Home School
Other
I am a Lassen County Graduating Senior
*
Yes
No
Graduate T-Shirt Size
*
Please Select
Small
Medium
Large
Extra Large
XXL
XXXL
XXXXL
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Parent/ Guardian Information
The following three questions will ask for parent/guardian information. This information is used in case of an emergency and to make contact should you or your guest leave the event before it ends to let them know that you are going to be leaving early.
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Parent/Guardian Email
*
example@example.com
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Health Information
Please provide the answers to the questions below.
Physician's Name
*
First Name
Last Name
Physician's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Physician's Phone Number
Please enter a valid phone number.
Medical Insurance Carrier
*
Medical Insurance ID#
*
Hospital used in an emergency
Allergies/Medical Limitations
Current Medications/Dosage/ Time Given
I understand that if my child has had a fever over the last 24 hours or has been vomitting during that time that they are not eligible to attend the event.
*
Yes
No
I understand that reasonable measures will be taken to safeguard the health and safety of all participants, and that I will be notified as soon as possible in the event of an emergency. In the event of an emergency, if I cannot be reached. I hereby authorize transportation to a medical facility, and/or calling of my child's physician at my expense, to provide the necessary medical treatment of my child. Parent/Guardian Signature
*
Submit
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