Night Out Request Form

  • Night Out Request Form

  • This form must be submitted 5 WEEKDAYS in advance of the date you are requesting to spend the night out. Approval of this request is contingent on verification of the provided information. Also requester must not be on restriction from any SRN department. Should restriction be imposed after the request is approved, the approval will be revoked. 

    Note:

    • Students are permitted to request one night per month
    • If the person requesting out is a minor,
      • permission to request out must have been granted by parent/guardian at SRN agreement signing
      • the adult listed on the request must provide transportation to and from night out destination
  • SRN House*
  • Date requesting to leave*
     - -
  • Date requesting to return*
     - -

  • Requesting to stay the night out during the week (Sunday, Monday, Tuesday, Wednesday, and/or Thursday) is not allowed. Requests to stay the night out must be either Friday or Saturday. Exceptions may be made during holidays/school breaks.

  • Exceptions for Night Out Requests Sunday-Thursday may be made ONLY for holidays/school breaks.

  • An individual aged 25 years or older must be present during your entire night out. They are required to provide valid identification to our office. This is a mandatory requirement, no exceptions allowed. Please let involved person(s) know that ID will be requested when SRN verifies the details of this Night Out Request.

  • Format: (000) 000-0000.

  • For minors (students not yet 18 years old), the adult listed on this request must provide transportation to and from the night out destination. 

  • If approved, students must arrive back at the SRN house before their curfew on the day of their return.

    • Time out requests by students who are 15-year-olds must align with pre-approved times determined by the office
    • Students who are 16 years old have an 8 pm curfew 
    • Curfew is 10 pm for anyone 17 years old and over 

  • Department Approval:

  • House Manager:*
  • Social Services:*
  • Academic Department:*
  • Programming:*
  • Financial:*

  • Students and Managers complete the section below after receiving approval from the office. 

    I, {studentName}, understand my Night Out Request from {dateRequesting} to {dateRequesting13} has been approved. I will make sure I am back before my curfew - {whatTime} - on the day of my return, {dateRequesting13}. 

  • Should be Empty: