2020 Rhode Island Night to Shine Guest Registration
Join us on Friday, February 7, 2020 from 6-9pm at the Newport Marriott for a Prom Night you will never forget. Walk the red carpet, enjoy the royal treatment, and dance the night away!

Once your registration is submitted, you will receive a confirmation email with your responses. If you do not receive a confirmation, please email nts@oceanpointeri.com. This could be because the submission did not go through or there was a typo in the email. Thank you for joining us for Night to Shine 2020!
Email address *
SEATING IS LIMITED - EVERYONE ATTENDING MUST PRE-REGISTER
First Name: *
Your answer
Last Name: *
Your answer
Name as you would like it to appear on name tag: *
Your answer
Date of Birth: *
MM
/
DD
/
YYYY
Age: *
Your answer
Gender: *
Address (please include city, state and zip code): *
Your answer
Phone Number: *
Your answer
Fun Fact About You:
Your answer
Favorite Song/Artist
Your answer
Will guest be coming with a DATE(other than caretaker)? *IF YES, please be sure to also fill out the next section. *
Emergency Contact During Event (Name): *
Your answer
Emergency Contact Phone Number: *
Your answer
Health or Allergy Concerns: *
Your answer
Wheelchair / Accessibility Device Dependent: *
Special Mobility Needs (cannot use stairs, etc): *
If yes, please explain
Your answer
Special Communications Needs: *
If Special Communications are needed, please explain:
Your answer
Please list any Major Physical/Developmental/Behavioral/Sensory Concerns (ie. seizures with strobe lights, down syndrome, pica, sensitivity to loud noises, autism, etc.) *
Your answer
Please describe guest's response/reaction if there were to be an emergency evacuation of any kind, so we best know how to help them: *
Your answer
RED CARPET: Does guest need to bypass the red carpet experience for any reason? (Sensory/Other) We will have a separate entrance for this purpose. Please let us know by checking the box below.
Food Needs (food cut-up or pureed, gluten-free, etc.):
Your answer
Will medication need to be administered during event? (Please note that OceanPointe 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.): *
How will Honored Guest be getting to & from the event? *
Required
Parent / Caretaker Name(s) *
Your answer
Parent / Caretaker Phone Number(s): *
Your answer
Parent / Caretaker will: *
*PLEASE NOTE* The Marriott catered dinner is served to Honored Guests ONLY. NTS provides the RESPITE Room for Parents and Caretakers- a private area where parents/caretakers will spend the evening enjoying dinner, dessert, and rest while remaining onsite during the event. *For guests who need constant care; we will provide a buddy who can bring caretakers food as well. *
Required
How many Parent / Caretakers in your group will enjoy the RESPITE Room? *
Your answer
Care Provider Agency Name (if attending as a part of a group, please include agency or company name):
Your answer
Care Provider Agency Phone Number:
Your answer
Care Provide Agency Chaperone (if applicable - note, chaperone is not required to stay with guest(s) unless required by Care Provider Agency):
Your answer
*PLEASE NOTE* Guests attending with Residential Agency/Care Provider Agencies/Group Homes will eat dinner at 5pm. Registration for groups will be open at 4pm. For all other guests, registration opens at 5pm, and dinner will open at 6pm. *
Required
Additional Notes or Concerns:
Your answer
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