School Dance Guest Authorization Release Form

Argyle Central School

Guest Authorization Release

Permission is hereby granted for Argyle Central School to receive information regarding:

Guest Name_____________________________ Guest’s Date of Birth____________

(print full name only-no nicknames) Guest’s Phone No. _____________

Guest’s Address: _________________________________________________________

Argyle Student’s Name: ___________________________________ Grade: ______

Activity requesting to attend: _______________________________ Date: _______

Guest Signature:__________________________________________ Date: _______

Guest Parent/Guardian Signature: ____________________________ Date: _______

Emergency Contact Person and Phone Number: _________________________________


*High School/GED graduates, one year out, may be considered after a formal interview with the High School Principal (no one 21 years of age or older may attend as a guest regardless of graduation year.)

To be completed by School Administrator of Guest


The person named above has been invited to an Argyle Central School function by an Argyle student. Please complete the following information so that we may obtain some background on the guest. Thank you for your assistance.

School currently attending __________________________________________________

If guest is not in school, check here and attach employment information. 

Is the student currently in good standing in your school? Yes  No 

Does the student have a record of drug/alcohol/violence or other serious violations of school policies? Yes  No 

If yes, please explain (be specific as to dates, etc…) ______________________________


Name of person filling out form: ______________________ Title: _____________

(Print) (Print)


Please forward information to:

 7-12 Principal

OR Fax to: 638-6373 Argyle Central School

By: _____________________ 5023 State Route 40

Argyle, NY 12809