Night To Shine Guest Registration
Marion First Church of the Nazarene is excited to be one of the nearly 500 churches around the world to host Night to Shine 2019, sponsored by the Tim Tebow Foundation, simultaneously on Friday, February 8, 2019. Night to Shine is an unforgettable prom night experience, centered on God’s love, for people with special needs ages 14 and older.
Every guest of Night to Shine enters this complimentary event on a red carpet complete with a warm welcome from a friendly crowd and paparazzi. Once inside, guests receive the royal treatment, including hair and makeup stations, shoe shining areas, limousine rides, corsages and boutonnieres, a catered dinner, prom favors, a dance floor… all leading up to the moment when each guest is crowned king or queen of the prom.
Please feel free to contact Cathy Waddell at 740-360-6283 or cmwaddell99@gmail.com or Emily Kauble at 740-262-4254 or emikauble@gmail.com with any questions.
Email address *
Full Name: *
Your answer
Name as you would like it to appear on nametag: *
Your answer
Age/DOB: *
Your answer
Gender: *
Address: *
Your answer
City: *
Your answer
State: *
Your answer
Zip code: *
Your answer
Phone: *
Your answer
Fun Fact About You: *
Your answer
Emergency Contact during event: *
Your answer
Emergency Contact Phone: *
Your answer
Health Concerns: *
Your answer
Wheelchair/Accessibility Device Dependent: *
Special Communication Needs: *
If yes, please explain:
Your answer
Sensory Issues/Concerns (strobe lights, camera flashes, loud noises, etc.): *
Your answer
Allergies:(Please list any that apply: foods, animals, latex, makeup, plants or pollen, etc.) *
Your answer
Food Needs (food cut-up or pureed, gluten free, etc.): *
If yes, please explain:
Your answer
Will Need Medication Administered During Event: * Please note that 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 dropped off and picked up by a parent/caretaker?
Will guest be taking public transportation to and from event?
Will guest be attending as a part of a group that will provide transportation?
Care Provider Agency Information – If Applicable. Care Provider Agency: (If attending as a part of a group, please include agency or company name)
Your answer
Care Provider Agency Phone:
Your answer
Agency Chaperone (if applicable): (Note: Chaperone is not required to stay with guest(s) unless required by Care Provider Agency)
Your answer
Additional Notes or Concerns:
Your answer
A copy of your responses will be emailed to the address you provided.
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