Langley High School ANGP 2019

LHS 2019 All Night Grad Party, June 3-4
Parent or Guardian's Name*

First NameLast Name
Parent or Guardian Email*

Confirmation Emailexample@example.com
Student's Name*

First NameLast Name
Student's Email*

Confirmation Emailexample@example.com

What would you like to do?*

Purchase ANGP ticket, $85I already purchased my ticket but need to submit the Parent/Student Authorization Form

Phone Numbers Parents can be reached during ANGP
Phone Number 1*
Phone Number 2
Parent Email during ANGP*

Confirmation Emailexample@example.com
This email address will be used to contact you during the ANGP if necessary. It may be different than the email address you entered earlier, which is used to send you confirmation of the information entered on this form.

All seniors attending ANGP 2019 must have this form on file for admission to ANGP.

Parental Authorization and Acknowledgement of Risk & Langley High School ANGP Disclaimer
- I understand that participation in this activity involves public property and that neither the LHS 2019 All Night Graduation Party Committee nor its parent volunteers will have any responsibility for the condition of use of this property. I have been made aware of the purpose of this activity and understand that there are a variety of events in which my child may choose to participate.
- I agree that my child is physically able to safely engage in these events. Also, I have been given the opportunity to have my questions concerning this event answered to my satisfaction. I have provided the reach number (listed below) for the ANGP Committee to use to notify me should my child fail to check in between 11:00 PM and 12:00 AM (midnight) on June 3, 2019 or request to leave the party before 4:00 AM on June 4, 2019.
- I will not hold the Langley High School PTSA liable for any accident in which I/my child has contributed in a negligent manner toward injury. Should an at-fault accident occur, my/my child’s own medical insurance will be the primary coverage.
Student Signature*

Clear
Student Name*

First NameLast Name
Confirm Student Name*

First NameLast Name
Date*

MonthDayYear
Date
Parent Signature*

Clear
Parent/Guardian Name*

First NameLast Name
Confirm Parent/Guardian Name*

First NameLast Name
Date*

MonthDayYear
Date

Total ($)
Amount Due

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USDANGP
After you click the Submit button, you will be taken to PayPal to make your payment. You can pay by PayPal or Credit/Debit Card. This form will not be submitted until after your payment has been completed.
Thank you for filling out the waiver. After you click the Submit button, you will receive an email copy of the waiver.
For questions or concerns, please contact Beth Harkaway at bethkharkaway@gmail.com
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