2026 Night to Shine Guest Registration Form

2026 Night to Shine Guest Registration

Host Church St. Mary's Catholic Church
We are so excited to celebrate Night to Shine with all of our special guests! We cannot wait to see you on February 13, 2026!

Night to Shine will be held at the Elks Lodge, 709 S. Fremont St., Shenandoah, IA on Friday, February 13, 2026 from 6 pm to 9 pm.

If you are registering multiple residents from your facility, please do a registration for each person attending. This helps us make sure we have accurate counts for those attending to be sure we have gifts for everyone and enough guest buddies to help make our guests feel special.

If you do not receive a reply email after registering, then something went wrong and you should attempt to register again. If you still don't receive an email reply, please email saintmaryoffice.shen@gmail.com and let us know so we can resolve the issue.

If you have any questions or concerns, please reach out to us at saintmaryoffice.shen@gmail.com and someone will get back to you promptly.

Thank you. We can't wait to see everyone's smiling faces in February 2026!
Special Guest Information
Guest Name*

First NameLast Name
Does the guest have a preferred nickname?
Guest Date of Birth*

MonthDayYear
Date
Age Age*
Prom King or Queen*

Male/KingFemale/Queen
List any allergies the guest has
Does the guest have any communication needs? (Such as non-verbal, communication board, sign language, etc.)
Does the guest have any sensory issues such as sensitivity to light and sound, touch, etc? Please describe.
Guest Phone Number*
Guest Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
All special guests are provided with a buddy for the night to share all of the fun with. Will the special guest bring their own buddy?

YesNo
If yes, what is that person's name?
To assist with registration, will the guest be checking in individually or with a group (such as group homes, assisted care facilities, roommates, etc.)?

Guest will check in on their ownGuest will check in with others from their group home or roommates
Agency/Group Information
Group Home Name or Agency Name
Agency Chaperone
Agency Phone Number
Additional Contact Information
Name of person completing this registration

First NameLast Name
PLEASE NOTE: This email address will be used to confirm your registration as well as communicate with you regarding the event. Please make sure it is accurate and it is an email account that you check often.
Email*
example@example.com
Phone # for person filling this form*
Primary Contact for Guest during the event for emergencies*

First NameLast Name
Phone Number for Primary Contact during the event for emergencies*
Relationship to guest
Name(s) of those who plan to stay:
To abide by the guidelines of The Tim Tebow Foundation, all adults who plan to stay with the guest must be background checked. Please email Tiffany Doyle at tiffanydoyledre@gmail.com.
I agree to release all rights for any of the pictures and/or video that will be taken during the Night to Shine event of me and/or my family members, including minors, for use by St. Mary's Catholic Church and/or the Tim Tebow Foundation. These uses include but are not limited to a highlight video and promotional material.

AcceptDo not use my picture
By providing my initials below, I agree to the above media release. (In the case of a minor or individual unable to complete this form, a Parent or Legal Guardian can initial in his/her place. A staff member may initial AFTER obtaining Parent or Legal Guardian's consent.)
Is there anything else you need to share with us that we have not already asked in this registration that will help us understand your needs?
Should be Empty:

2026 Night to Shine Guest Registration

We are so excited to celebrate Night to Shine with all of our special guests! We cannot wait to see you on February 13, 2026!

Special Guest Information

Agency/Group Information

Additional Contact Information