Night To Shine 2025 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

Fun Stuff

One thing we are fortunate to be able to offer you is the opportunity to borrow 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.):

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

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.

How will the guest be getting to the event?

Dropped off by a parent/caretaker Public Transportation Attending with a group that is providing transportation

How will the guest be picked up from the event?

Picked up by a parent/caretaker Public Transportation Attending with a group that is providing transportation

Please provide the name of the person/agency that will be picking up the guest

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 as a parent/Enjoying the Respite Room. (Must fill out volunteer registration so we can acquire a background check.) Attending with the Guest as their buddy. (Must register as a Volunteer)

If enjoying Respite Room, how many?

Who will be the guest's buddy?

Guest needs to be assigned a buddy Guest's caretaker/chaperone/parent will be their buddy Guest is requesting to be with a specific buddy

If caretaker/chaperone/parent will be their buddy, what is their name?

If requesting a specific buddy, who do you wish to be paired with?

* 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):

Care Provider Agency Phone:

Agency Chaperone (if 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 2025 Guest Registration Form

Description

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