Enchanted Evening Grad Night 2021 Waiver
This form is required to be filled out by BOTH the parent/guardian and the Grad Night participant by May 10, 2021.

PARTICIPANTS WILL NOT BE ADMITTED WITHOUT THIS FORM. Please fill out one form for each participant and submit it when you purchase your ticket.

BE SURE TO PURCHASE YOUR TICKET at https://checkout.square.site/buy/Q3ZEBNOVSZ645Q4O7PFGNWNI after submitting this form.
Email *
GRAD NIGHT PARTICIPANT: LAST name *
GRAD NIGHT PARTICIPANT: FIRST name *
GRAD NIGHT PARTICIPANT: EMAIL to receive SignUpGenius to request seating and possible updates about Grad Night. *
GRAD NIGHT PARTICIPANT: CELL PHONE as a backup for updates/reminders *
PARENT/GUARDIAN: LAST name *
PARENT/GUARDIAN: FIRST name *
PARENT/GUARDIAN: EMAIL to receive updates/reminders about Grad Night *
PARENT/GUARDIAN: CELL PHONE to be used in case of emergency. *
Safety and Security Requirements and Procedures
PLEASE READ COMPLETELY AND CAREFULLY:

1) CHECK-IN:
a) Arrive early between 5:00-6:00pm to check in before the gate closes at 7:00pm. Security lines may be long.
b) No admittance after 7:00pm
c) Participants must have a picture ID such as a Dublin High School senior ID or Driver’s License or CA ID.
d) No Bags/Purses/Backpacks are allowed on the fairgrounds.
- Leave purses/backpacks/bags at home or in your vehicle at your own risk.
e) Metal detection wands and breathalyzers will be used with each participant before entry..
-Anyone failing the breathalyzer test will not be allowed to enter.
f) Temperature Check: Participants must have a temperature under 101 F to be admitted

2) COVID-19 SAFETY PROCEDURES
a) Masks: All participants and volunteers must wear masks unless eating or drinking.
b) Social Distancing:
- All participants and volunteers must remain socially distanced throughout the event.
- Participants are not allowed to change seats.

3) BEHAVIORAL ISSUES
a) The participant will be refused admittance or required to leave for the reasons listed below.
- Participant is found with weapons, incendiary devices, or illegal material.
- Participant is found in possession, using, or deemed under the influence of illegal substances
(including alcohol, vaping, drugs, cigarettes)
- Participant is involved in illegal activity
- Participant Is deemed to be a danger/ threat to themselves, others or property
- Participant disrupts the event or the running of the event.
- Participant does not follow the Safety and Security Requirements and Procedures
- Participant does not follow directions of law enforcement/volunteers in adherence to the Safety and Security Requirements and Procedures outlined in this form.
b) The participant will not be allowed re-admittance or a refund.
c) Law enforcement or parent/guardian may be contacted to be responsible for the participant
d) This applies in the parking lot, Fairgrounds and surrounding areas.

4) IF A PARTICIPANT LEAVES ON THEIR OWN:
a) There is no re-admittance
b) There is no refund
c) Dublin High School PFSO and its volunteers are not responsible for participants when they leave.
d) Dublin High School PFSO and its volunteers cannot legally detain participants to remain at the event.

5) THERE ARE NO REFUNDS WITH THE FOLLOWING EXCEPTIONS:
a) The event is forced to be cancelled.
- Refunds will be made but less the processing fees and non-refundable deposit fees
PARENT/GUARDIAN: Safety and Security Requirements and Procedures read, understood, and agreed to *
Required
PARENT/GUARDIAN: Full name as a signature *
Today's Date *
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GRAD NIGHT PARTICIPANT: Safety and Security Requirements and Procedures read, understood and agreed to *
Required
GRAD NIGHT PARTICIPANT: Full name as a signature *
Today's Date *
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PARENT/GUARDIAN APPROVAL PARTICIPATION WAIVER
The following waiver is required by the Dublin High School PFSO for the Grad Night Participant listed at the beginning of this form. We are requiring this waiver for all participants, even if 18 years old.

The undersigned parent(s) or guardian(s) assume all risks in connection with the participation of all individuals listed as the Grad Night Participant at the beginning of this form in any and all of the Dublin High School PFSO sponsored activities.

I attest and verify that all individuals listed as a Grad Night Participant are physically fit and able to participate in any PFSO sponsored activities. Further I acknowledge that it is my responsibility to understand any inherent risks associated with PFSO sponsored activities and communicate those risks to all individuals named above.

I do hereby certify that to the best of my knowledge and belief that the Grad Night Participant is in good health. In the event that I, or other parent/guardian, cannot be reached in an emergency, I hereby give permission to secure proper treatment for my child/children. 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 hereby advise that the above named participant has the following allergies, medicine reactions or unusual physical conditions, which should be made known to a treating physician, and which I have listed below.

I/we, as parent(s) or guardian(s) of the Grad Night Participant, do hereby, for my child/children, myself, my heirs, executors and administrators, release and forever discharge and hold harmless the Dublin High School PFSO, the Dublin Unified School District 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 PFSO sponsored activities. By filling in the full name below as signature, I confirm that I have carefully read and fully understand the contents of the Parent/Guardian Approval Participation Waiver. I am aware that this is a release of liability and signed it of my own free will.
List allergies, medicine reactions or medical conditions (if none then write "none") *
PARENT/GUARDIAN: Parent/Guardian Approval Participation Waiver read, understood and agreed to *
Required
PARENT/GUARDIAN: Full name as signature *
Today's Date *
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STUDENT PARTICIPATION WAIVER
This is required of all DHS Students participating in the Grad Night 2021, if the Grad Night Participant is 18 years or older by May 29, 2021. Please read it completely and carefully.

This student participant waiver, release and indemnity agreement is between Dublin High School PFSO and the Grad Night Participant named in the beginning of this form if the participant will be 18 or older on or before May 29, 2021.

PARTICIPANT WAIVER: I voluntarily agree to participate in Dublin High School PFSO sponsored events and activities held during the school year. I recognize that the Dublin High School PFSO has not undertaken any duty or responsibility for my safety and I agree to assume the full responsibility for all risk of bodily injury, death, disability, and property damage as a result of participating in PFSO sponsored events and activities. I recognize that these risks will vary based on the event and activity, and understand it is my responsibility to be aware of the risks before participating. I attest and verify that I am mentally and physically fit and able to participate in PFSO sponsored events and activities and willingly and voluntarily accept these risks. By filling in my full name as my signature below, I hereby surrender any right to seek reimbursement from the Dublin High School PFSO, the Dublin Unified School District, and all of their officers, directors, members and volunteers for injury sustained and liability incurred during my participation in Dublin High School PFSO sponsored events and activities.
GRAD NIGHT PARTICIPANT: Student Participation Waiver read, understood and agreed to *
GRAD NIGHT PARTICIPANT: Full name as a signature. Fill in "minor" if you will NOT be 18 years old on or before May 29, 2021. *
Today's Date *
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ACKNOWLEDGEMENTS

1) Parent/Guardian and the Grad Night Participant will be responsible for informing Dublin High School PFSO, in the event that within the 10 days leading up to and including May 29, 2021:
a) The Grad Night Participant has had a positive COVID-19 test; or
b) The Grad Night Participant has had a known exposure to COVID-19.

2) Parent/Guardian and the Grad Night Participant further acknowledge that despite all precautions taken by the Dublin High School PFSO, there is a risk of exposure to COVID-19 by attending Grad Night 2021, and that attendees know and understand the risk and absolve Dublin High School PFSO and Dublin Unified School District of all liability.
PARENT/GUARDIAN: ACKNOWLEDGEMENTS read, understood and agreed to *
Required
PARENT/GUARDIAN: Full name as signature *
Today's Date *
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GRAD NIGHT PARTICIPANT: ACKNOWLEDGEMENTS read, understood and agreed to *
Required
GRAD NIGHT PARTICIPANT: Full name as a signature *
Today's Date *
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AFTER SUBMITTING THIS FORM, BE SURE TO PURCHASE YOUR GRAD NIGHT TICKET BY MAY 7, 2021.
A copy of your responses will be emailed to the address you provided.
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