Participant Registration Form
* 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 medication.
If enjoying Respite Room, please limit to two Parents or Caretakers.
* The Respite Room is a private area where parents/caretakers of guests can spend the evening enjoying food, entertainment, and rest while remaining onsite during the event.
Care Provider Agency Information- If Applicable
If attending as a part of a group, please include agency or company name.
Note: Chaperone is not required to stay with guest(s) unless required by Care Provider Agency. If Chaperone remains with guest, a Background Check will be required.
Thank you for registering for Night To Shine. See you there!