Group Home Sign Up fall Bash 2019
For Group Homes only! If you are a part of a group, but not a group home, please sign up Individually on the other form.
Email address *
Group Home Name *
Your answer
email *
Please check to make sure email address is correct. If it is not you will not receive an email confirmation. We will not do any other confirmations by Facebook, phone, text, or another email. Also please add us to your contacts so that emails from us do not end up in the spam folder! Thanks.
Your answer
Wristbands Needed (guests + staff staying) *
Your answer
School District where you live or attend (for grant writing purposes) *
School District group home is located in.
Your answer
Cell phone number of staying staff member *
example: 6168878213 Please include the area code.
Your answer
1 more Emergency Phone Number *
example: 6168878213 Please include the area code.
Your answer
Phone number to call in case of dance cancellation or questions *
example: 6168878213 Please include your area code.
Your answer
Will staff carry an Epi-Pen for a client? *
If you need a Best Prom Ever organizer to contact you regarding a special concern or question please name the topic below.
Your answer
I, do hereby consent and agree that Best Prom Ever, its employees, or agents have the right to take photographs, videotape, or digital recordings of me beginning on Nov. 9, 2019, and ending on Nov. 9, 2019 and to use these in any and all media, now or hereafter known, and exclusively for the purpose of promotion, advertising, guest use, seeking sponsors, donors, and grants. I further consent that my name and identity may be revealed therein or by descriptive text or commentary. I do hereby release to Best Prom Ever, its agents, and employees all rights to exhibit this work in print and electronic form publicly or privately and to market and sell copies. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used. I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback. I also understand that Best Prom Ever is not responsible for any expense or liability incurred as a result of my participation in this recording, including medical expenses due to any sickness or injury incurred as a result. Pictures or video of the event may be used for the purposes of promoting and seeking funding for the Best Prom Ever. *
Required
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