Night to Shine- Guest Registration
Join us for Night to Shine sponsored by the Tim Tebow Foundation and LaGrange First Church of God
on Friday, February 7, 2020 from 6:00-9:00 p.m.
At Farmstead Expo Barn
Registration closes January 18, 2020. Open to the first 200 guest.

Prom Closet will also be hosted on January 18, 2020 at LaGrange First Church of God. Open to all guest to find the perfect dress or suit and have it altered and ready for Night to Shine, free of charge.
Full Name *
Your answer
What Name would you like to be called?
This will be on your name tag
Your answer
Date Of Birth (Month, Day, Year)
Your answer
Address (Number and Street) *
Your answer
Address (City, State and Zip code) *
Your answer
Phone number
Your answer
Email *
Your answer
Gender *
** Used to help us order the correct number of Crowns and Tiaras.
Would you like to be scheduled for a Salon appointment for the event, starting at 5:00 p.m.?
Guest can get their hair and makeup done by professionals before and at the start of the event. We will notify you of your schedule time slot and group appointments together by agencies.
Care Provider Agency (If applicable) *
If coming with a group, please list the name of organization bringing you to help with registration. If independent, just list none. To help with Registration flow we will schedule appointment times for large groups coming with the same agency.
Your answer
Emergency Contact information *
Please include name and phone number of who to contact in case of an emergency during the event
Your answer
List any allergies
(food, animals, latex, make-up, plants, pollen, etc)
Your answer
Dietary restrictions *
If other to Dietary Restrictions, please specify
Your answer
Any medical conditions we should be aware of *
Your answer
Wheelchair or Accessibility Device Dependent?
Will Medication need to be administered during the 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.
Any Special communication
If other listed for communication needs, please explain
Your answer
Sensory issues/Concerns
For Example: strobe lights/camera/loud noises
Your answer
Is anyone planning to accompany you?
We will have a respite room for family and caregivers. If a caregiver would like to be a buddy to you as a guest, please have them register under the volunteer/buddy registration page. They can request to be paired with you.
If yes, please list who is attending and their title
example: (Name: Father) or (Name: Agency Representative)
Your answer
How will you be transported to and from the Event?
Any other special considerations
Your answer
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