Brownstown Prom 2.

To ensure we are meeting safety suggestions by our state government and venue requirements*
we will take the following action as a precautionary measure during this time of Covid-19.
Please read the information and answer where directed. If you agree to attend our event knowing
we will be making our best efforts to observe current recommended safety guidelines, please
sign the bottom of the form prior to purchasing your tickets. Please feel free to ask questions
and/or mention concerns prior to event.
Answer/Initial below:

● Name:__________________________________________________ Age:___

Name of Guest:___________________________________________ Age:___

● Acknowledge you and your guest are feeling healthy with no fever or symptoms of any virus
or sickness and in the event of this changing after the purchase of tickets and prior to PROM 2.0,
you understand you should not attend if having symptoms._____

● Will you and your guest be wearing masks _____

(Although it is not mandatory, we will have some available if needed.)

● Do you understand we will do our best to keep a good social distance. We will also require
your assistance in maintaining social distancing. Tables may have no more than 6 guests. We
will work to provide a very open dancefloor. We ask that you limit your close contact of others
to people you have already been in close contact with (i.e. your date) _____

Once you have read the above and attend at your will and risk during this time.
Please date & sign for you and your guests. ___/___

Attendee signature: _______________________________________________

Guest signature:___________________________________________________

Name of parent or guardian of attendee if under age 18:_______________________________

Signature of parent or guardian of attendee:_________________________________________

Name of parent or guardian of guest if under age 18:__________________________________

Signature of parent or guardian of guest:____________________________________________

*Refrain from the use of drugs, alcohol. Respect the property and attendees. Chaperones and law
enforcement will be present.