Guest Registration | Night to Shine at cfParis

Guest

First name * Last name *

Name on nametag

Date of birth Gender

Address

City State ZIP

Email * Phone

Fun fact about you

Emergency contact during the event

Listed on the guest nametag.

Name Phone

Arrival Medication will need to be administered during the event

Church staff and volunteers are not responsible for administering medication. A parent or caretaker must be available if medication is required.

Dropped off and picked up by parent/caretaker? Taking public transportation? Attending with a group that provides transportation?

How we can support you

Optional. Share only what you are comfortable sharing.

Health concerns Mobility needs Communication needs Sensory issues (strobe lights, camera flashes, loud noises) Allergies (foods, animals, latex, makeup, plants, pollen) Food needs (cut-up or pureed, gluten free, dairy free, nut free) Anything else we should know

Caretaker Caretaker name(s)

Caretaker phone Relationship to guest

Caretaker will be If Respite Room, caretaker names

Care provider agency — if applicable Agency or company name

Agency phone Chaperone name

Chaperone cell

A chaperone who remains with the guest needs a current background check.

Media release

Night to Shine is hosted by Christian Fellowship Church and sponsored in part by the Tim Tebow Foundation. Photos and video may be used by the church and the foundation for charitable purposes. Signing below (checking this box) gives that consent for the guest named on this form.

I agree to the media rights release for this guest * The guest is 14 years of age or older *

Register as an honored guest