Night to Shine Guest Registration
* First Name
* Last Name
* Name as you would like it to appear on your name tag:
* Fun Fact About You:
* Birth Date
* Mobile Phone
* Emergency Contact during Event:
* Emergency Contact Phone Number
* Health Concerns:
* Wheelchair/Accessibility Device Dependent:
* Special Communication Needs:
If yes, please explain:
Sensory Issues/Concerns (strobe lights, camera flashes, loud noises, etc):
* Sensory Entrance & Check In Requested
Allergies? Please list any that apply: foods, animals, latex, makeup, plants or pollen, etc.
* Food Needs: (food cut-up, or pureed, dairy free, gluten free, etc.)
* Will Need Medication Administered During Event: *Please note that Calvary Chapel, 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?
* Will guest be taking public transportation to and from this event?
Unsure at this time
* Will guest be attending as a part of a group that will provide transportation?
- Every guest must have a parent or caretaker listed on their registration.
* Parent/Caretaker Name(s):
* Parent/Caretaker Phone:
* Parent/Caretaker E-mail:
* Parent/Caretaker will be... * Tip: 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.
Dropping Guest Off
Enjoying Respite Room
* If enjoying Respite Room, how many? If no, please put a zero. *
Additional Notes or Concerns
Guest - Buddy Pairing: A buddy will be provided by our Night to Shine staff for you.
- It is our goal at Night to Shine to provide a full night of fun and respite for all guests and their families. Our staff is prepared to match your needs with a registered volunteer buddy. If you request a specific person to be your buddy, that individual MUST complete the volunteer registration form on this event page. If they do not complete the volunteer registration, they will not be permitted to enter the event.
Name of requested buddy:
Care Provider Agency Information - If Applicable
- If attending as a part of a group, please include agency or company name)
Care Provider Agency:
Care Provider Agency Phone:
Agency Chaperone (if applicable): NOTE Chaperone is not required to stay with guest(s) unless required by Care Provider Agency
Add Another Person
Processing registration ...