Prince of Wales Prom 2011

Registration form

Complete ALL applicable fields below. Print neatly, illegible forms will not be processed.
Attendee Information

First Name: Last Name:

Phone (Mobile): (Home):

Birthdate: MM / DD / YYYY Email:

Address Line 1: Gender: MALE FEMALE

Address Line 2: City:

Country: Postal Code: Province:

Dietary Preference: VEG. KOSHER NO MILK OTHER:

I will be attending with a date from Prince of Wales, currently in Grade 12. (Fill out Gr.12 PW)

I will be attending with a date from another school, or from another grade at Prince of Wales (Fill out Other)

Guest Information (Gr.12 PW)

First Name: Last Name:

Guest Information (Other)

First Name: Last Name:

Phone (Mobile): Birthdate: MM / DD / YYYY

School: Gender: MALE FEMALE

Dietary Preference: VEG. KOSHER NO MILK OTHER:

Payments will be accepted by Cheque only. Incorrectly addressed cheques will not be accepted, no exceptions.

For the amount of: Payable to: This form must be submitted by:

$145/person PW Prom 2011 April 15, 2011

 Code of Conduct:
All guests are expected and required to conduct themselves accordingly. Rude, obnoxious or
inappropriate behavior will not be tolerated. Should a guest be found to be conducting him/herself in an
unacceptable manner or engaging in inappropriate behavior as deemed by their peers, the organizer(s),
other guests or any staff members of a partner organization or establishment, the individual will be asked
to leave the premises at the discretion of the organizer(s), Vancouver Convention Centre staff, and/or the
designated Parent Chaperones. All expenses incurred in ensuring the safety of a removed person(s),
without exception, will be the sole responsibility of the individual(s) in question.

Terms & Conditions:

Ticket holders/buyers and attendees, from here forth referred to as the "Client" agree to the following by
usage of this ticket and/or attendance to PW Prom 2010 from here forth referred to as the "Event": The
Client voluntarily assumes all risks and dangers incidental to the Event, and waives all claims against the
Event and its affiliates, including but not limited to the organizers, owner/staff of the venue, its partners
and service providers. The Guest assumes and acknowledges all responsibility and consequences of his/
her actions throughout the duration of the Event, including full financial compensation should any damage
occur as a direct or indirect consequence of his/her actions. The ticket issued for the Event is a revocable
license subject to termination with denial of admission at the sole discretion of, or upon a violation of the
terms, rules, guidelines or conditions set by, the Event and its affiliates. A refund will not be issued should
a Client be refused admission or face ejection due to a violation of these terms. The Client assumes and
acknowledges all responsibility and consequences of his/her actions throughout the duration of the event,
including full financial compensation. The Client consents to a search for drugs, weapons, alcoholic
beverages, or any other items prohibited on the premises upon entry into the venue and at any time
during the Event. The Client also agrees and acknowledges that such items are not permitted on the
premises. A valid ticket must be presented by the Client for admission into the event, with 1 piece of ID.
The Client shall be granted entrance upon confirmation that the ticket number, registration number and
the ID are a match. The Client will not be granted entrance, without exception, if he/she is not able to
present a valid ticket upon entry. The Client agrees to and acknowledges any additional terms set by the
Event and its affiliates.

Cancellations/Refunds:
All lost, stolen or damaged tickets will be subject to a $25 replacement fee + $5 administration fee.
Refunds will only be issued in the event of an extraneous circumstance, as determined by the organizers.
Refunds are subject to a $50 deposit + $5 administration fee. All applications for refunds must be made
14 days prior to the Event. No applications for refunds will be accepted within 14 days of the Event.

Note: Your signature below acknowledges that you have read, understood, and agreed to the Code of
Conduct, Terms & Conditions, and Cancellations/Refunds policy outlined above, for both YOURSELF
AND YOUR GUEST. You are liable and responsible for your guestʼs actions throughout the Event. Should
either yourself or your guest be found in violation of the Event policies, BOTH individuals will be asked to
leave the premises, without exception. All expenses incurred as a result of your eviction and arrangement
of safe transportation will be the responsibility of the individual(s) in question.

I, have read, understand and agree to the policies outlined above.

Student Name (Please print clearly)

Date: MM / DD / YYYY
Student Signature