GUEST REGISTRATION FORM

Gender:

Will Need Medication Administered During Event:

* 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.

The following documents are required to be submitted with your registration.  Please select, download, complete, sign  and save each document, then attach it below:

Media Rights Release for Honored Guests

Media Rights Release for Parent/Caretaker (if required)

Liability Waiver

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

Will guest be taking public transportation to and from event?

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

We would love to make your Night to Shine experience the best it can possibly be.  If you are comfortable sharing, please answer any of the following optional items that apply in order to help us offer the best support we can.

Caretaker will be:

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

Note: Chaperone is not required to stay with guest(s) unless required by Care Provider Agency.  If Chaperone remains with guest, a current Background Check will be required.)