Night to Shine - 2019
February 8, 2019
Held at the
Troy Crystal Room
For guests 14 years of age and older
* First Name
* Last Name
* Name as you would like it to appear on your nametag
* Birth Date
* Address 1
* Zip/Postal Code
* Home Phone
* Emergency Contact Name & Number
* Specific Health Concerns for us to be aware of during the event
* Does this guest use a wheelchair?
* Does this guest have Special Communication Needs? If so, please explain.
Does this guest have any Sensory Issues/Concerns (strobe lights, camera flashes, loud noises, etc.)?
Please list any that apply (food, latex, make-up, etc.)
* Food Needs:
Does this guest need any food cut up, pureed, gluten free, etc.? If yes please explain.
- Please note that Troy Christian 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 this guest need medication administered during the Night To Shine event?
- Information about the parent or caretaker of our guest.
- As a parent/caretaker you have one of three options during the night of the event.
1-Bring the honored guests for an unforgettable prom experience. Parents/caretakers are encouraged to accompany their loved ones through the registration process along with cheer on their honored guests as they walk the red carpet.
2-Stay on campus throughout the event and enjoy the provided Respite Room. We ask all participants of the Respite Room to RSVP below.
3-Participate in the eventís activities with your loved one as a Buddy. Buddies are a Night To Shine volunteer position and ALL VOLUNTEERS must register at the
Night To Shine volunteer page
,be background checked and provide a media release
RESPITE ROOM REGISTRATION
- The Respite Room is a private area where parents/caretakers of guests can spend the evening enjoying food, entertainment and rest while remaining on site during the event.
Parent/Caretaker will be:
Enjoying Respite Room
Volunteering as a Buddy
If enjoying the Respite Room, how many?
CARE PROVIDER AGENCY INFORMATION - If Applicable
- If applicable, please include information about the care provider agency.
If a care provider of this guest needs and/or desires to stay with the guest throughout the event said provider MUST register as a volunteer Buddy.
Please inform care provider that registration is mandatory in order for them to accompany/stay with this guest throughout the event.
Register on the
Night To Shine volunteer page
Name of Care Provider Agency and name of the individual working with agency. If attending as part of a group, please include agency or company name.
Care Provider Agency Phone
- If there is a certain individual already registered to be a volunteer Buddy for the event and you would like to request your loved one be partnered with him/her, please list the Buddy's name below.
Add Another Person
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