I request permission for a leave of absence from the highest authority in my life for the following period:
Time of return
Date: Time of departure: NOT to exceed:
Should permission be granted, I do solemnly swear to only visit the locations stated below, at the stated times. I agree to refrain from hitting on or flirting with other women. I shall not even speak to another female, except as expressly permitted in writing below. I will not turn off my mobile after two pints, nor shall I consume above the allowed volume of alcohol without first phoning for a taxi AND calling you for a verbal waiver of said alcohol allowance. I understand that even if permission is granted to go out, my girlfriend/fiancé/wife retains the right to be pissed off with me the following week for no valid reason whatsoever.
Amount of alcohol allowed (units) Beer Wine Liquor Total
