Jesus Prom 2025 Guest Registration

Jesus Prom 2025 Registration
Doors open at 6:00 p.m. Activities will conclude at 9:30 p.m.

Jesus Prom is a night for those 16 years of age and older with special needs. This is an exciting night that includes dinner, games, a salon area to touch up hair and makeup, a take-home gift, karaoke, dancing, and photos. Once the doors open at 6:00 pm, you will arrive to a red carpet welcome and then be directed to the sign-in area. You will be given your name tag and a guide that will assist you throughout the evening. After you are signed in, you can choose whatever activity you would like to do first. Since Karaoke is a favorite event for many of the prom guests, you could start there or maybe begin with photos or visit the hair salon area. Dinner will be served from 6:00-8:00. Whenever you or your friends are ready to eat just go to the Banquet Hall. If seating is not available right then, your guide will be notified when your seats are available. A guide will be available to assist you throughout the evening.

Parents and caregivers remaining at the church during the prom are invited to make a reservation for their dinner on the registration form. Dinner for the parents and caregivers is served in the Caregiver Room on the 2nd floor at 6:30 p.m.

Each person wishing to attend Jesus Prom must complete the following registration form. Registrations are limited. To avoid being disappointed, please register as soon as you know you will be attending. Once the limit is reached, registration will close. There will be no on-site registration on the night of prom.

ONE FORM MUST BE COMPLETED FOR EACH GUEST.

Guest Information

Guest refers to the special needs individual who is attending the prom. Information for parents & caregivers will be asked on a separate section of this form.
Guest's Name*

First NameLast Name
Guest's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Guest's Phone Number*
Please enter a valid phone number.
Guest's Email*
example@example.com
Guest's Birthday*

MonthDayYear
Guest's Gender*

Food Allergies and Special Dietary Requirements
Do you have any food allergies or dietary requirements?*

YesNo
Please list them:
Guides

For the safety and protection of all guests at Jesus Prom, everyone attending will be assigned a guide. If you plan to attend with friends please let us know so we can assign guides accordingly.
Please select one of the two options:*

I am coming to Jesus Prom by myselfI am coming with friends to Jesus Prom
Please list your friend(s) names (Providing a name(s) here does not register them as a guest):
Providing a name(s) here does not register a guest. Please register each guest separately.

Caregiver Information

Caregiver refers to the parent or legal guardian of the guest.
Caregiver's Name*

First NameLast Name
Caregiver's Phone Number*
Please enter a valid phone number.
Caregiver's Email*
example@example.com
Caregiver's Relationship to the Guest*
Caregiver Reservation
Please let us know what your plans will be while the guest is enjoying the prom activities.*

No parent or caregiver will be present at the prom.It is absolutely necessary for a parent or caregiver to remain with the guest for the duration of the prom.I will join the other caregivers/parents for dinner in the Caregivers Room located on the 2nd floor at 6:30 pm.
Please list the name of the one parent or caregiver that will be accompanying the guest all evening.*

First NameLast Name
Please list the e-mail of the one parent or caregiver that will be accompanying the guest all evening.*
example@example.com
Please note that this person will need to remain with the guest for the entirety of the guest's time at Jesus Prom (6:00-9:30pm)
Will additional caregivers be joining us for dinner in the Caregiver Room?*

YesNo
Name

First NameLast Name
Relationship to the Guest
Name

First NameLast Name
Relationship to the Guest
Name

First NameLast Name
Relationship to the Guest

Additional Information
Are there any special circumstances we should be aware of?
During Jesus Prom there will be photographers and videographers capturing memories of the evening. By attending you give us your permission to utilize images and recordings for the promotional purposes of the church, including but not limited to: website, print publications, and social media. If you would like to attend but do not want to have your image used please contact us at 330.336.4622 or jesusprom@northsideweb.org
IMPORTANT

You will receive a "Thank You" notification once your registration is submitted. If you do not see this message, please look over the registration to see if information is missing and submit again. If you still do not receive this message, please call the church office at 330-336-4622 and we will assist you.
Should be Empty:

Jesus Prom 2025 Registration

Guest Information

Food Allergies and Special Dietary Requirements

Guides

Caregiver Information

Caregiver Reservation

Additional Information