New Haven Pride Prom Registration
Welcome to the New Haven Pride Prom registration page! The Pride Prom will be at 8PM on Saturday, April 30 at the United Church on the Green Parish House (323 Temple St.). If you plan on attending, please provide the following information in the spaces below. Before you complete your registration make sure you read the important information at the bottom of this page. If you have any questions, please call (203) 548-7766.
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Name (First and Last) *
High School *
What year are you in school? *
Note: only current high school students may register for the dance. If you are accompanying a high school student as a date but are not currently in high school, you will have to fill out a form when you arrive at the dance.
Email address
If you have one.
Emergency contact *
If you feel uncomfortable having your parents as your emergency contact, please write down the name of another trusted adult.
Emergency contact phone # *
Please put down a phone number for the above person.
How did you hear about this event? *
Required
Please read the following statement and mark the checkbox below when you are done. *
I understand that this is an alcohol and drug free event.  By registering for the event, I acknowledge such fact, and agree to not attend if under the influence of alcohol or drugs.  I also agree to not bring alcohol or drugs to the event and I acknowledge that I have voluntarily and freely elected to attend this event.  I understand and agree that Fierce Advocates and Yale University and/or its representatives assume no liability in the event of accident or illness, nor for damage or injury to person or property of any nature whatsoever.  I voluntarily and freely assume all risk of accident, injury, illness or damage to or loss of property, and Fierce Advocates and Yale University shall not be responsible to any person for my acts or omissions.
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