Guest Registration: St. Catherine & St. Francis
To Register: Participants must be 14 years of age or older by Feb 8, 2019
Email address *
Guest (Participant) Information
To Register: Guests must be 14 years of age or older by Feb 8, 2019
Participant's First Name *
Your answer
Participant's Last Name *
Your answer
Street *
Your answer
City *
Your answer
State *
Your answer
ZIP *
Your answer
Contact phone *
Your answer
Date of Birth *
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Age as of February 8, 2019 *
Your answer
Gender *
FIRST NAME as you would like it to appear on the Participant's name tag *
Your answer
RED CARPET INFORMATION: Please tell us about the Participant's favorite movie, pet, game, stuffed animal, sport, etc. that we may use to announce at his/her arrival. *
Your answer
PROM BUDDIES (dates)
We have over 100 volunteers Buddies/dates who can't wait to accompany our Guests to Night To Shine. Please answer the following questions to help us match our buddies with each Participant. Some guests may choose to have a friend, family member or personal assistant as their Buddy/date. If so, this person MUST REGISTER as a Volunteer/Buddy.
Does this Participant have a prearranged date who will be registering as a Buddy? *
If Yes, this Buddy MUST register. Please provide their full name, phone and email address.
Your answer
Please describe this Participant's special needs *
Your answer
Level of supervision this Participant requires from their prom Buddy (date) *
Does this Participant use a wheelchair or have mobility needs? *
If YES, please explain.
Your answer
Does this Participant have any special communication needs? *
If YES, please explain.
Your answer
Does this Participant have any sensory issues? (Strobe lights, camera flashes, loud noises, etc.) *
If YES, please explain.
Your answer
Would this Participant prefer a "Quiet" entrance without flash photography and cheering? *
We want to make this evening a happy event for this Participant! In order to help us understand his/her needs, please explain what, if anything, makes this Participant nervous, upset or agitated? *
Your answer
List any allergies (food or otherwise) *
Your answer
Is this Participant part of a group or agency (for seating purposes)? Examples include Special Olympics, Spectrum, Explorers, DPD, Red Ribbon Academy, None *
Your answer
Prom Activities
Prom Activities are open to all participants throughout much of the evening. Activities include Karaoke, Photo Booth, Shoe Shine, Hair & Make up Salon, Sensory Room and Limousine ride. Special permission is only required for the Limousine Ride, which takes place during the prom. Participants will take a supervised 5-minute ride in the neighborhood behind the church.
Limousine Ride *
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