REQUEST FOR A LATER CURFEW

   

I, ______________________________(name of child) , on this day ____________________________ (date)

have
asked to have  my curfew extended from ______________________ (current curfew)   to

 __________________
(requested curfew).

  

I am asking to have my curfew extended on _____________________ (date) because I want to
  
__________________________________ (reason for request i.e. school dance).    I understand that 
  
his is a one-time extension and that my curfew will remain ____________________
(current curfew) on

all other nights following this event.  I was  informed by ___________________ 
(Mom and/or Dad) 

that should I break this curfew on ________________________  (date of event)  that I will  _____________
 
______________________________________________ 
(punishment for breaking curfew).     

 

I understand and agree that I will also need  to __________________________________________
  
__________________________ 
(i.e.: call home, call at a certain time etc.)  in order to be granted an extension
 
on my current curfew.  I agree to all of these terms.
  
 

 
 
 
______________________________         ____________________________             _________
    Childís Signature                                     Parentís Signature                                    Date