Night To Shine 2024 Guest Registration Form

Today's Date

Guest Contact Information

Name

Name as you would like it to appear on nametag:

Age

Gender

Male Female

Phone

Address

Will you be attending our in-person event or virtual?

Fun Stuff

One thing we are fortunate to be able to offer you is the opportunity to rent a dress or suit if you do not already have one. We are planning our fitting appointments in the coming months and will let you know as soon as they're scheduled.
Please note that we have limited sizes and may not be able to provide everyone with a dress or suit.

You are absolutely welcome to wear anything you feel comfortable in, and casual apparel is just fine! We just ask that it is appropriate and modest.

I Would Like More Information On Dress/Suit Fittings

Fun Fact About You:

Medical Information

Emergency Contact During Event:

Emergency Contact Phone

Health Concerns:

Wheelchair/Accessibility Device Dependent:

Yes No

Special Communication Needs:

No Yes (if yes, please explain below:

Special Communication Needs (if yes above):

Sensory Issues/Concerns (strobe lights, camera flashes, loud noises, etc.):

Please Write N/A If Not Applicable.

Allergies (Please list any that apply: foods, animals, latex, makeup, plants or pollen, etc.)

Please Write N/A If Not Applicable.

Will Need Medication Administered During Event:

Yes No

* Please note that the church, their staff and volunteers are not responsible for administering medication to guests during the Night to Shine event. If medication is required during the event, a parent or caretaker MUST be available to administer the medication.

Will guest be dropped off and picked up by a parent/caretaker?

Yes No

Will guest be taking public transportation to and from event?

Yes No

Will guest be attending as a part of a group that will provide transportation?

Yes No

Parent/Caretaker Information

All parents/caretakers who will be attending the event must complete the volunteer registration form at https://connectionpoint.info/nts.

This ensures that we have background checks on everyone attending.

Parent/Caretaker Name(s):

This address will receive a confirmation email

Parent/Caretaker Phone:

Parent/Caretaker will be…

Dropping Guest Off Attending Event/ Enjoying the Respite Room. (All Guests must register as a Volunteer) Attending with the Guest. (All Guests must register as a Volunteer)

If enjoying Respite Room, how many?

* The Respite Room is a private area where parents/caretakers of guests can spend the evening enjoying food, entertainment and rest while remaining onsite during the event.

Care Provider Agency Information

If the guest attending will have a Care Provider Chaperone through an agency, please have the Chaperone fill out the Night to Shine Volunteer Form as well.

Care Provider Agency (If attending as a part of a group, please include agency or company name):

Please Write N/A If Not Applicable.

Care Provider Agency Phone:

Please Write N/A If Not Applicable.

Agency Chaperone (if applicable):

Please Write N/A If Not Applicable.

Additional Notes or Concerns:

Connect Church Liability Release

Click HERE to view the Connect Church Liability Release.

I Agree to the Connect Church Liability Release Form

Today's Date:

Participant's Name:

Signature: Please type your full name here

Night To Shine Parent/Caretaker Media Rights Release

Click HERE to view the Night To Shine Parent/Caretaker Media Rights Release.

I agree to and accept the Night to Shine Parent/Caretaker Media Rights Release

Signature: Please type your full name here

Night To Shine 2024 Guest Registration Form

Description

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