Guest Registration

***PLEASE NOTE: We have reached our maximum capacity and our waiting list is full.

Please click here to see other locations that are having the Night to Shine event.

Wheelchair/Accessibility Device Dependent:
Special Communication Needs:
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 the medication.
Will guest be dropped off and picked up by a parent/caretaker?
Will guest be taking public transportation to and from the event?
Will guest be attending as a part of a group that will provide transportation?
Parent/Caretaker Information
Parent/Caretaker will be:
Will wheelchair access be required to upper floor Respite room?
Care Provider Agency Information - If Applicable
***Note: Chaperone is not required to stay with guest(s) unless required by Care Provider Agency

Please Download, Fill-Out, And Submit Both The Media Rights Release and Liability Forms In Addition To Completing The Volunteer Form On The Website. You May Also Drop Them Off At The Church Address Monday-Thursday, 9:00am to 4:00pm. ***THESE ARE REQUIRED.

Media Rights Release Form
Liability Release Form