Jonathan Law High School: Junior Cotillion 2026 GUEST PERMISSION SLIP

Jonathan Law High School: Junior Cotillion 2026 GUEST PERMISSION SLIP

JLHS NON-JUNIORS OR NON-LAW STUDENTS
When:

Friday, April 17, 2026 from 6:00pm-9:00pm

No student can arrive after 6:45 PM

No student can leave before 8:00 PM

Where:

The Patterson Club
1118 Cross Hwy, Fairfield, CT 06824

Payment Information:

$95 per person

Payment due Friday, April 3
No tickets will be sold after April 3

Online Payment
(Please contact school if alternative payment option is necessary)

-- IMPORTANT --

-- You will receive an email receipt for confirmation. --

-- Please bring up your confirmation email on your phone or have a print out --
For any questions, please reach out to:

Stacy Loch
Your Information
I am attending with (JLHS Junior name):*

JLHS Junior First NameJLHS Junior Last Name
Your Name*

First NameLast Name
Your Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
YesNo
School You Attend*
Please attach copy of your photo ID:*

Cancelof
Your Grade Level*
Your Email Address (This is where the confirmation email will be sent. Please enter twice to avoid typos.)*

Confirmation Emailexample@example.com
Parent/Guardian and Emergency Contact
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Phone Number: *
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
I give permission for for my student to leave school at 10:30am on April 17I do not give permission for for my student to leave school at 10:30am on April 17My child is not a student at JLHS
As a GUEST, I agree to the following:
- Arrive at the dance free of the influence of any illegal substance; comply with all legal and safety rules of Jonathan Law HS and the building, eg. no smoking/vaping, no drinking, no drugs, no trespassing in areas so designated.
- Dance in a manner that is appropriate for a school dance.
- Follow Milford Public Schools’ school rules.
- Once you leave the dance, you cannot return.
Administrators reserve the right to call an adult to pick up those individuals, who, in their opinion, have violated these expectations.

A high school administrator or designee will administer a breathalyzer test at all school sponsored dances to all students and their guests (Policy #5131.65). I understand that if my date or I fail the breathalyzer test then we will be subject to the consequences deemed necessary by an administrator or the police.

I understand that in order to ensure my safety, the parent/guardian of my guest (JLHS Senior) will be called if I do not arrive at the venue by 6:45 PM or leave the dance prior to 8:00 P.M.

I have read, understand, and agree to the information above.
As a parent/guardian, I give my child permission to attend the dance.
I agree to the expectations of the dance (Your printed name)*

Student First NameStudent Last Name
Your Signature*
Parent/Guardian: I have read, understand, and agree to the information above. As a parent/guardian, I give my child permission to attend the dance. *

Parent/Guardian First NameParent/Guardian Last Name
Parent/Guardian: Signature*

My Products

Law HS Junior Cotillion 2026

Enter description

$95.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Please click the Submit button only once

It may take a few minutes for the transaction to go through

Please check your SPAM/JUNK folder in your email account if you do not receive the confirmation email

Ticket sales are final and can not be returned or exchanged.
Should be Empty:

Jonathan Law High School: Junior Cotillion 2026 GUEST PERMISSION SLIP

Please click the Submit button only once

It may take a few minutes for the transaction to go through

Please check your SPAM/JUNK folder in your email account if you do not receive the confirmation emailTicket sales are final and can not be returned or exchanged.

Please check your SPAM/JUNK folder in your email account if you do not receive the confirmation email

Ticket sales are final and can not be returned or exchanged.