SUA Prom - Saint Ursula Events

Student Name*

First Last

Email

Grade level*

Junior
Senior

What type of ticket do you want to purchase?*

Ticket for myself only
Ticket for me and my date
I've already purchased a single ticket but need to purchase a ticket for my date.

By signing below, I agree that I have read the stated regulations regarding the Saint Ursula Academy Prom and I will adhere to the regulations. To read the entire list of regulations, click HERE.

Student Signature*

Parent(s) Name(s)*

Phone number for student's parent to be reached the night of prom*

Alternate phone number for parent*

The undersigned is a natural or legal guardian of the above mentioned minor and releases Saint Ursula Academy, its trustees, officers, administrators, employees, and agents from any and all liability of whatever nature relating to or in any manner arising out of the use by such minor of the Saint Ursula Academy's program(s) and/or facilities. Furthermore, the undersigned agrees to indemnify and hold harmless Saint Ursula Academy, its trustees, officers, administrators, employees, and agents, from any all all damages, expenses or other losses arising from or in connection with any suit, or other legal proceedings or otherwise, including attorneys' fees with respect to the use of Saint Ursula Academy's program(s) and/or facilities or any part of them by the minor named above. This release and indemnification shall be binding upon the personal representatives, heirs and assigns of the undersigned and the minor named above. I acknowledge that I have full power of authority to sign this document on behalf of the above minor, that I have read the foregoing paragraph, that I understand it, and that I have the option to have it reviewed by legal counsel prior to signing, and that I freely execute this document on behalf of the above mentioned minor.By signing below, I agree that I have read the stated regulations about the expectations set for my daughter regarding the Saint Ursula Academy Prom and I expect her to adhere to the regulations. I understand that Saint Ursula Academy may ask me to pick her up if she does not adhere to the regulations, and that her money will not be refunded if she is asked to leave. To read the entire list of regulations, click HERE.

Parent Signature*

By signing below, I agree that I have read the stated regulations and the release of liability regarding the Saint Ursula Academy Prom and I will adhere to the regulations.

Name of Date*

First Last

Name of date's high school*

Phone number for date's parents to be reached the night of Prom.*

Someone should be available to answer this phone number between the hours of 7:00pm and 12:00am on April 24.

Alternate phone number for date's parents*

Someone should be available to answer this phone number between the hours of 7:00pm and 12:00am on April 24.

Total

$0.00

Saint Ursula Academy Prom

April 24, 7:00pm - 12:00am

Paul Brown Stadium