Elementary Campus:
710 Franklin Street
Williamsport, PA 17701

Phone: 570.326.3738
Junior/Senior High School Campus
& Administrative Offices:

901 Penn Street
Williamsport, PA 17701

Phone: 570.323.9953
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Home > Guest Form

Guest Form

We/I the parent/guardian of _________________________, request permission for our student to bring _____________________________, who is a student of _______________________, as a guest to an SJNRA event. We/I assume full responsibility for this student guest during the function.

Name and Date of Event__________________________________

Parent Signature_________________________________________

Phone Number__________________________________________

Today’s Date____________________________________________

**The remainder of this form to be completed by the guest**

*All guests of SJNRA student’s must present a photo ID at the event.*

*No guest over the age of 20 will be approved.*

The above student is in good standing at __________________________________________ and in grade________.

School Administrator’s Signature________________________________________________

Title_______________________________________________________________________

I will abide by all rules, procedures, and directions of any adult in a supervisory position while at the event held at St. John Neumann Regional Academy. I understand that failure to do so will result in my being dismissed from the event and/or sanctions being imposed on me by local law enforcement.

SJNRA Guest Signature__________________________________ Date______________

SJNRA Guest Birth Date and Age____________________________________________

Parent/Guardian of Guest Signature__________________________________________

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