Lake Campus Minor Overnight Guest Form Copy

Wright State University-Lake Campus defines a guest as “any person who does not hold a residential contract or lease for the particular residential unit they are occupying at the time.

The following permission form is required when any minor visiting visits a Housing unit without their parent or legal guardian present, past our posted quiet hours, which is when a minor would be considered an "overnight" guest.

• This form must be completed and submitted at least five (5) business days prior to the date of the stay.

When a minor visits without their parent or legal guardian, they must be accompanied by their student host at all times while they are in the residential units and on campus.

All Campus Housing policies must be followed by the guest during the stay, and the resident must obtain approval of their roommate(s) and all suite unit mates before the stay begins.

This form must be completed and signed by the minor’s parent or legal guardian.

As this minor’s parent or legal guardian, I grant permission for the minor named below to visit the residential units at Wright State University. I understand that the student host is completely responsible for the welfare of this minor.
Furthermore, I agree to pick up the minor upon request by the University or the host student. Parent/Legal Guardian Signature: *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Minors Name:
Age & Date of Birth:
Arrival Date: Arrival Date: / MM / DD YYYY
Time: Time: : HH MM AM/PM
Departure Date: Departure Date: / MM / DD YYYY
Time: Time: : HH MM AM/PM
WSU Resident/Host's Name:
Resident/Host's Residential Unit Number & Building:
Resident's Cell Phone Number: Resident's Cell Phone Number: - ### - ### ####
Parent/Legal Guardian's name:
Parent/Guardian's Home Address:
City/State/Zip:
Parent/Guardian Cell Phone: Parent/Guardian Cell Phone: - ### - ### ####
Does the minor have any medical conditions that we need to be aware of?
Email
Email