"Junior" Honored Guest (Ages 13 and Under) Registration - Night to Remember 2020
This form is only for our "junior" honored guests - ages 13 or less!!

Details for our Junior Honored Guests:
WHEN: Sunday, June 14, 2020
WHAT: Our junior honored guests will enjoy a ride in our limo, professional photography, a walk down the red carpet and a fun night of dancing! (must be accompanied by a parent / guardian)
WHERE: Monona Terrace, 1 John Nolen Drive, Madison, WI
WHO: Kids (ages 13 and under) with special needs in the greater Madison area
COST: Free!

We are SO EXCITED to have you join us for Night to Remember 2020!
Junior Honored Guest Information
Please fill out the following information for the junior guest attending Night to Remember 2020
Child's Name *
Your answer
Parent / Guardian Name *
Your answer
Primary Email *
*** IMPORTANT *** Please double check your email for errors. This is the primary email address we will communicate with; please designate an email that should receive all communications with details of the event. We don't want you to miss anything!
Your answer
Primary Phone Number *
Our primary method of communication is through email, but we will also keep a primary phone number on file if we need to reach out for any reason.
Your answer
Address Line 1 *
Your answer
Address Line 2
Your answer
City *
Your answer
State *
Postal Code *
Your answer
Birthdate *
Must be 13 years old or younger to register as a "junior" honored guest (on June 14, 2020)
MM
/
DD
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YYYY
Help us call your child by the proper pronoun *
Is there any other information that would be helpful to know about this "junior" honored guest?
Your answer
How did you hear about A Night to Remember? *
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