Ceasar Limousine Prom Permission Form

Name of Student:_______________________________________

School Name:__________________________________________

Date of Prom:__________________________________________



I __________________________ give my consent to have your

limousine company chauffeur my son/daughter __________________

and friends to their destination as they requested.



Number in Party:_______________________________________

Other Destinations (club, lodging, etc.)______________________

________________________________________________ ______

If crossing a state line, indicate destination:__________________

________________________________________________ ______



THANK YOU FOR YOUR COOPERATION

Parent/Guardian Signature:_______________________________

Emergency Telephone Number:___________________________

Fax to:

Ceasar Limousine, Inc.
Fax: (609) 383-9064