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Participant Registration Form

Guest Information
Gender
Wheelchair/Accessibility Device Dependent
Special Communication Needs
Food Needs (food cut-up or pureed, gluten free, dairy free, nut free, etc.)
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 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?
Parent/Caretaker Information
Parent/Caretaker will be...
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!

Sorry, online participant registration for Night To Shine 2024 has now closed. You may still attend and register onsite when you arrive at Night To Shine. We apologize for any inconvenience.

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