PACIFIC COAST LEARNING CENTER
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A separate form must be submitted for each student, but multiple tickets may be purchased at once.
*
Indicates required field
Attendee Name
*
First
Last
Name of Attendee's School
*
*Any high-school age students are welcome to attend, regardless of school affiliation.
*Anyone over the age of 18 who is not enrolled at PCLC must attach a copy of his/her CA ID card and specify which PCLC student he/she is accompanying to the dance. No attendees over the age of 20 will be permitted inside the event.
**NOTE: there are no physical tickets for this event. Students will be on a check-in list at the door.
Student's Current Grade
*
Parent/Emergency Contact Phone on 4/24
*
PCLC students may be accompanied to the dance by non-PCLC students who are over the age of 18, but not over the age of 20. If this applies to you, please list the name of the PCLC student you will be attending the dance with, and upload a copy of your CA ID or driver's license.
Name
*
First
Last
Upload File
*
Max file size: 20MB
All attendees of the PCLC Winter Formal must adhere to the dress and conduct code.
DRESS:
Ladies: Hemlines/dress slits must be longer than student's fingertips when standing with arms at sides. No cleavage may be shown.
Gentlemen: Dress shirt and tie must be worn. No jeans.
CONDUCT:
All students will remain in the designated dance area for the duration of the event, unless met by a parent at the entrance.
Students will refrain from any form of sensual physical contact during the dance.
Attendees agree to respect dance supervisors and fellow students.
COVID-19 ASSUMPTION-OF-RISK, WAIVER AND INDEMNITY AGREEMENT
Concerning the COVID-19 and associated viruses, it is my desire to attend an event at Pacific Coast Learning Center, and as a condition to receiving such services and consent for the association, I freely and voluntarily assume any and all risk of exposure, and freely and voluntarily assume all risk that my student, my family members, and/or I may be exposed to a virus by the association, including when attending onsite classes.
I fully understand that exposure is possible even with efforts by Pacific Coast Learning Center to employ protective measures, and infection is a possibility and may result in personal injury, illness, disability, or death. I freely and voluntarily agree to assume all the foregoing risks, and to hold harmless Pacific Coast Learning Center and all its affiliates, agents, employees, and representatives from any and all liability, claims, actions, damages, costs, or expenses of any kind arising out of or relating thereto.
I understand and agree this release includes any claims based on the actions, omissions, or negligence of Pacific Coast Learning Center and all its affiliates, agents, and representatives in connection with viral infections, whether an infection occurs before, during, or after my student’s, my family’s, or my own participation in any activities on campus or in any program-related activity.
I agree to indemnify Pacific Coast Learning Center and its affiliates, agents, employees, and representatives from any legal claim or action (in relation to damages claimed because of a viral infection) taken against Pacific Coast Learning Center and/or its affiliates, agents, employees and/or representatives by or on behalf of my student or my family members (children, siblings, spouses, parents, or other relatives), and such indemnity is on all claims related to any viral infection, and includes damages, costs, expenses, and attorney’s fees incurred in defending against such claims or actions.
Electronic Signature
*
Student and guardian agree to the above.
Submit
Spring Formal Ticket
$75.00
Purchase Ticket
Home
2021/22 Schedule
Onsite Schedule
Online Schedule
REGISTER
Satellite Academy
Campus Info
Spring Formal
Family Info Form
FACILITY FEES
Calendar
Contact
FAQs
Senior Spotlight
Cater Tots Lunch Program
Study Hall
COVID-19 Info
Handbook
Movie Night