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Night to Shine 2018
Welcome to Night to Shine Registration! We hope that you will be able to join us on Friday, February 9, 2018 for a wonderful evening of fun, music, dancing, food and so much more! This year's event is again hosted by First Presbyterian Church Douglasville in collaboration with Crossroads Church, who will be hosting the event on their campus this year. We are very excited to have the opportunity to host even MORE guests in 2018!

Please complete the registration form below and submit it online as soon as you can! We want you to join us for the biggest party of the year!

You will receive a confirmation email upon submission of the completed form.

Email address *
GUEST First Name *
Your answer
GUEST Last Name *
Your answer
GUEST Preferred Name (for NameTag) *
Your answer
Age *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Address *
Your answer
City *
Your answer
State *
Your answer
Zipcode *
Your answer
Phone Number *
Your answer
Emergency Contact Name (during Event) *
Your answer
Emergency Contact Phone Number *
Your answer
Health Concerns: *
Your answer
Wheelchair/Accessibility Device Dependent? *
Special Communication Needs? *
If Yes above, please explain:
Your answer
Sensory Sensitivities or Concerns? (strobe lights, camera flashes, loud noises, etc.) *
If Yes above, please explain:
Your answer
Allergies (list any that apply)[food, animals, latex, makeup, plants, pollen, etc,]: *
Your answer
Food Needs? (cut up, pureed, gluten free, etc.) *
If Yes above, please explain:
Your answer
Will Medication Need To Be Administered During Event? [Please note: 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. *
Will GUEST be picked up/dropped off by a parent/caretaker? *
Will GUEST be taking public transportation to/from Event? *
Will GUEST be attending as part of a group that will provide transportation? *
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