Night to Shine Honored Guests
(6 spots left)
Welcome to the Night to Shine Honored Guest Registration page
!
Night to Shine, sponsored by the Tim Tebow Foundation will be held at The Chapel Sandusky on Friday, February 9, 2024.
Honored Guest Information
* Name as you would like it to appear on name tag:
* First Name
* Last Name
* Full Date of Birth (mm/dd/yyyy) * Ages 14 and above only, please for Night to Shine Guests.
* Gender
Female
Male
* Current Address: STREET
* Current Address: CITY
* Current Address: STATE
* Current Address: ZIP CODE
* Email
* Phone Number (xxx-xxx-xxxx)
* Emergency Contact During Event: NAME (will be listed on guest's name tag)
* Emergency Contact: PHONE (xxx-xxx-xxxx) This will be listed on guest's name tag.
* Wheelchair / Accessibility Device Dependent:
Select one
Walks Independently
Utilize Wheelchair
Utilize Walker / Cane
* I communicate:
Select one
Verbally
With a Communication Device
Gestures or Sign Language
* Allergies: (Please list any that apply: foods, animals, latex, makeup, plants or pollen, etc. -Or Type: None)
* Food Needs:
Puree
Cut-Up
Gluten Free
Dairy Free
Diabetic Friendly
Other
* Will Guest Need MEDICATION Administered During Event?
Select one
Yes
No
**If medication is required during the event, a Parent or Caretaker MUST BE AVAILABLE to administer the medication.
* Will Guest Need Toileting Assistance?
Select one
Yes, assistance needed in Restroom
No, assistance is not needed in Restroom
**If assistance with toileting hygiene is required during the event, a Parent or Caretaker MUST BE AVAILABLE to provide assistance.
* Will you be utilizing our Sensory Friendly Entrance? (No Cheering or Flash Photography)
Select one
No
Yes
* Additional Notes / Concerns You Would Like Us To Be Aware Of:
Respite Room : During Night to Shine respite activities and a meal will be offered for parent / care givers.
* Please select how many Parents / Caretakers will enjoy the Respite Room. Please limit to TWO Parents / Caretakers.
Select one
None
One
Two
Please list Full Name(s) of the (one and/or two) Parents/Caretakers who will enjoy the Respite Room:
Add Another Person
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