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EHT JUNIOR/SENIOR PROM 2015
“The Great Gatsby”
Page 1
EHT.K12.NJ.US – Available only online
Dear Juniors and Seniors:
We have conveniently placed the packet on the high school website for you to print out on your
own. If you do not have access to a computer, please see Mrs. DiMaio (E211) or Mr. Winkler
(D216) or feel free to use the Media Center to print your packet.
Please read ALL of the information enclosed! You will be responsible
for ALL parts of the packet!
You MUST have the following completed, submitted, and approved before you are able to
purchase your prom ticket:
1.
2.
3.
4.
“Prom Permission Slip” (page 3) for each person attending
SADD “Contract for Life” (page 4) for each person attending
“Transportation Form” (page 5) for each person attending
“Alumni/Out of District Approval Form” (page 6) – for any guest who does not currently
attend EHTHS
* SADD “Contracto de por vida” para estudiantes y padres que no hablan inglés (page 7) *
You and your guest must present a valid photo ID on the night of the prom. Failure to do so
may result in you not being able to enter the prom. DO NOT FORGET YOUR ID!
If you have any questions, please see Mrs. DiMaio (E211) or Mr. Winkler (D216) during
homeroom only. DO NOT INTERRUPT CLASSES WITH PROM QUESTIONS!
THIS PACKET MUST BE COMPLETED AND SUBMITTED BY Thursday, April 30TH
 Packets can be turned in at the meeting on April 1st at EHTHS (7:00 p.m.)
 Packets can be turned into Mrs. DiMaio or Mr. Winkler
NO LATE PACKETS WILL BE ACCEPTED! NO EXCEPTIONS WILL BE MADE!
Any other questions please contact Mrs. DiMaio or Mr. Winkler or through email
Parent or Guardian attendance at the Pre-Prom meeting at EHTHS (7:00 p.m.) is OPTIONAL
Reviewer Initials: ________
Page 2
Egg Harbor Township High School PROM PERMISSION SLIP
One completed form required per ticket.
TO BE COMPLETED BY THE PARENT AND STUDENT (REGARDLESS OF Age 18):
I, the parent/legal guardian of (Print Student/Guest Name)________________________________, hereby
give my consent to his/her participation at the Egg Harbor Township High School Junior/Senior Prom on
June 6, 2015 from 7pm to 11pm at the Wildwood Convention Center in Wildwood, New Jersey. I understand
that I hold the Egg Harbor Township School District, their officers, agents and employees, harmless from any
and all liability or claims, which may arise out of or in connection with my child’s participation in this activity.
Student or Guest
My attendance at the 2015 Egg Harbor Township High School Junior/Senior Prom means that I must comply
with all school rules that include the following:
1. No drinking, smoking or use of drugs before, during, or after the prom.
2. Any pupil suspected of being under the influence of but not limited to alcoholic beverages, controlled
dangerous substances, anabolic steroids, inhalants, and/or unauthorized prescription drugs on school
property or at any school sponsored event shall immediately be taken through the mandated steps as
outlined in the New Jersey Administrative Code, Title 6A: 16-6.1 and the Egg Harbor Township Board of
Education Policy and Procedures. These include immediate notification of the Administration, parents, and
Superintendent, immediate removal of the person or persons involved, and a referral to a medical facility
for examination and drug screening. Parents will be required to comply with the Administrative Referral
(AR) Process as outlined in the student handbook. There will be further disciplinary action for Egg Harbor
Township students upon returning to school. Criminal charges may be filed. If an EHT student is suspected
of being under the influence their guest will be offered a refund or the ability to continue with the prom.
3. The Egg Harbor Township Police Department will be notified of any student who is found to be in
possession of a controlled dangerous substance (CDS) and/or alcohol.
4. The administration and/or representatives reserve the right to search any bags and persons.
5. No inappropriate behavior on the dance floor or on the grounds of the Wildwood Convention
Center.
8. All students and guests must have a valid picture ID to enter the prom!
(NO ONE WILL BE ADMITTED WITHOUT A CURRENT VALID PICTURE ID.)
9. Students must arrive by 8:00 pm and may not depart until 10:00pm.
10. Refunds will not be issued if admission is denied for any reason.
11. Students are responsible for the behavior of their guests (must be under 21 years old) and both
will be escorted out of the dance without a refund if any violations of the school rules occur.
12. The administration reserves the right to refuse admittance to inappropriately dressed students
or guests.
13. See previous page for further clarifications of the rules.
NOTE: Only EHTHS students in the 11th or 12th grade may purchase tickets (9th and 10th grade
students may attend as a guest).
Page 3
Prom Permission Slip
I have read and understand the above stated rules. I understand that I am responsible for my actions and
those of my guest at all times and the Egg Harbor Township High School Student Handbook will dictate
the consequences for any infractions. In addition, I may be restricted from future Egg Harbor Township
High School activities, including graduation. (Parent/guardian MUST sign below regardless if the
student/guest is 18 years old or older.)
Student Name (print) _______________________________ School _________________
School ID#_______________ Student Signature ______________________Date _______
Parent/Guardian Name (print) _________________________________________
Parent/Guardian Signature ____________________________________________ Date _________
Home phone # _________________________ Emergency phone # _________________________
Guest’s Name (print) _____________________________ School ___________________________
Guest’s School ID#_______________________
Page 4
SADD Contract for Life
A Foundation for Trust and Caring
This Contract is designed to facilitate communication between young people and their parents about potentially
destructive decisions related to alcohol, drugs, peer pressure, and behavior. The issues facing young people
today are often too difficult for them to address alone. SADD believes that effective parent-child
communication is critically important in helping young adults to make healthy decisions.
EHTHS STUDENT (Print Name) _____________________________________________________________
I recognize that there are many potentially destructive decisions I face every day and
commit to you that I will do everything in my power to avoid making decisions that
will jeopardize my health, my safety and overall well-being, or your trust in me. I
understand the dangers associated with the use of alcohol and drugs and the destructive
behaviors often associated with impairment.
By signing below, I pledge my best effort to remain free from alcohol and drugs; I
agree that I will never drive under the influence; I agree that I will never ride with an
impaired driver; and I agree that I will always wear a seat belt.
Finally, I agree to call you if I am ever in a situation that threatens my safety and to
communicate with you regularly about issues of importance to both of us.
EHTHS STUDENT (Sign Name) _____________________________________________________________
PARENT/GAURDIAN (Print Name) __________________________________________________________
I am committed to you and to your health and safety. By signing below, I pledge to
do everything in my power to understand and communicate with you about the
many difficult and potentially destructive decisions you face.
Further, I agree to provide for you safe, sober transportation home if you are ever in a
situation that threatens your safety and to defer discussions about that situation until
a time when we can both have a discussion in a calm and caring manner.
I also pledge to you that I will not drive under the influence of alcohol or drugs, I will
always seek safe, sober transportation home, and I will always wear a seat belt.
PARENT/GAURDIAN (Sign Name) _______________________________________________
©2005 SADD, Inc., a Massachusetts nonprofit corporation. All rights reserved. SADD and all SADD logos are
registered trademarks of SADD, Inc. SADD chapters and their individual students have permission to reproduce
this material in its entirety for use by the students. Copying of this material by other entities (publishers or other
individuals), either in whole or in part, without written permission is strictly prohibited. SADD, Inc. sponsors
Students Against Destructive Decisions and other health and safety programs.
SADD, Inc. | 255 Main Street | Marlborough, MA 01752
Page 5
Transportation Form
To ensure the safety of our students, the administration has decided to provide transportation for all students to
the prom. The cost of this transportation is included in the price of the prom ticket REGARDLESS OF
WHETHER OR NOT YOU TAKE THE COACH BUS! Students may still choose to take their own
transportation to the prom in the form of a hired service only (i.e. limo) or parental drop off. However, they
must pay for this themselves and understand that they have still paid for the bus via their prom ticket.
STUDENTS MAY NOT DRIVE THEMSELVES TO THE PROM!
*VERY IMPORTANT* Students will decide whether they are taking the bus or not prior to purchasing their
prom ticket. Once you have notified us you may not change your mind to take the bus! Again, if you tell us
that you are taking a limo and your plans fall through, you will not be allowed to take the bus to the prom!
Please make your decision carefully and consider taking the provided transportation. It is safe, reliable and you
are paying for it anyway!
Yes, I will be taking the bus
Yes, my guest will be taking the bus
No, I will not be taking the bus to the prom. I understand that I am responsible for providing my own
transportation in the form of a paid service or parental drop off and that I may not drive myself or have another
student drive me to the prom.
I,________________________________________ (Print Name), have read and understand the above terms
and conditions regarding the transportation to the prom.
____________________________________________
Signature
_____________
Date
Page 6
Alumni/Out of District Student Approval Form
Egg Harbor Township Student: (Print)____________________
Any junior or senior who attends the prom with a date who is not a current Egg Harbor Township High School
student must have a guest permission form on file with the school. The guest may be either a freshman, sophomore,
junior, or senior in good standing from another high school or a high school graduate who is not yet 21 years old.
The guest must also agree to abide by Egg Harbor Township’s rules and must complete the prom packet!
Use FORM A if the guest is an Egg Harbor Township high school graduate.
Use FORM B if the guest attends a high school other than Egg Harbor Township.
FORM A (Guest is an EHTHS graduate.)
To be approved by an EHTHS Vice Principal
Guest’s contact information:
Name_________________________________
Address_________________________________________________________
Phone:_________________
Emergency contact: (Parent or Guardian) Name __________________________
Address_________________________________________________________ Phone:__________________
EHTHS Vice Principal approval:_______________________________
FORM B (Guest attends another high school.)
To be filled out by the guest’s Principal or Principal’s designee
This is to verify that __________________________________________ is a member in good standing of the _________
class at _________________________ High School and will be the guest of ______________________________ at the
EHTHS prom on Saturday, June 6th 2015.
Signed: ____________________________ (Principal or Designee)
School Contact Number: _____________
Guest’s contact information:
Name ______________________________________
Address _____________________________________________________ Phone_______________________
Emergency Contact (Parent or Guardian) ______________________________________________
Relationship to Guest _______________________________
Address _____________________________________________________
Phone__________________
CONTRATO PARA LA VIDA
Una Base para Confianza y Afecto
Page 7
Este contrato está diseñado para facilitar la comunicación entre los jóvenes y sus padres sobre las decisiones
con potencial destructivo con relación al alcohol, las drogas, la presión de otros jóvenes y su comportamiento.
Hoy los jóvenes se encuentran con problemas que son muy difíciles para confrontarlos solos. SADD cree que
la communicacion efectiva entre padres y jóvenes es sumamente importante para ayudar a los adolescentes
hacer decisiones sanas.
EL JOVEN (por favor escribe)________________________________________________
Yo reconozco que cada día me enfrento a muchas decisiones con potencial destructivo y le prometo a usted que
haré todo en mi poder para evitar las decisiones que podrían poner en peligro mi salud, seguridad y bienestar, o
su confianza en mi. Yo comprendo los peligros relacionados con el uso del alcohol y las drogas, y las conductas
destructivas asociadas con los efectos del alcohol y las drogas en el cuerpo.
Al firmar abajo yo prometo mis mejores esfuerzos para permanecer libre del alcohol y de las drogas. Yo
prometo que yo nunca conduciré bajo la influencia, yo prometo que nunca me montaré con una persona
manejando bajo la influencia y yo prometo que siempre usaré el cinturón de seguridad.
Finalmente, yo prometo llamarle a usted si estoy en una situación que amenaza mi seguridad y también prometo
comunicarme frecuentemente con usted sobre asuntos de importancia a nosotros dos.
EL JOVEN __________________________________________________________
EL PADRE (o Adulto Encargado) _________________________________________
Yo estoy dedicado a ti y a tu salud y seguridad. Al firmar abajo, yo me comprometo a hacer todo lo que está en
mi poder para comprenderte y comunicarme contigo sobre la multitud de decisiones difíciles con potencial
destructivo que tu confrontas.
Además, yo prometo facilitarte transportación sobria a casa si te encuentras en una situación que amenace tu
seguridad. También yo prometo posponer discusiones sobre esta situación hasta un tiempo cuando podamos
tener una discusión en una forma calmada y con afecto.
También yo hago la promesa de no manejar bajo la influencia de alcohol o de drogas. Siempre buscaré
transportación sobria a casa y siempre usaré el cinturón de seguridad.
EL PADRE/ADULTO ENCARGADO _________________________________________
Los Estudiantes Contra Las Decisiones Destructivas ____________________________
©2005 SADD, Inc., una organización sin fines de lucro de Massachusetts. SADD se reserva todos los derechos.
SADD y todos los logos de SADD son marcas registradas de SADD, Inc. Las filiales de SADD y sus propios
estudiantes tienen permiso de reproducir este documento en su totalidad para el uso de los estudiantes. Se
prohíbe la reproducción de este documento por otras entidades (casas editorials a otros individuos), o en
totalidad o en parte, sin permiso escrito. SADD Inc. patroniza a Students Against Destructive Decisions (Los
Estudiantes Contra las Decisiones Destructivas) y otros programas de salud y de seguridad.
SADD, Inc. | 255 Main Street | Marlborough, MA 01752 1-877-SADD-INC O GRATIS | 1-508-481-3568
NUMERO DE TELEFONO| 1-508-481-5759 FAX | www.sadd.org