Night to Shine Attendee Registration

Night to Shine Attendee Registration

Register to attend the Night to Shine event at Livingston Christian Center on Friday February 13th at 6:00pm.
Event Info:

Night to shine is an unforgettable worldwide celebration event, centered on God's love, honoring and valuing people with special needs. Dinner, Dance, Fun & Games, the Red Carpet Walk, Crowning Ceremony and More!
A Night to Shine, hosted by Livingston Christian Center
1400 Mt Baldy Drive, Livingston, MT 59047
Contact: office@livingstonchristiancenter.com | 406.222.3144
Guest Information
Attendee Full Name*

First NameLast Name
Preferred Name/Nickname
Attendee Email Address*
example@example.com
Attendee Phone Number*
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Date
Age at Event Date
Gender (optional)

MaleFemale
Do you have any dietary restrictions?
Do you require any special accommodations?
Every Special Guest will be paired with a buddy unless a parent, guardian, or caregiver chooses to serve in that role. If you plan to provide a buddy, they must complete a volunteer application. Will you be serving as or providing a buddy?*

YesNo
If yes, please provide the name of the "Buddy"
Caregiver/ Parent/ Guardian Information
Parent/Guardian/Caregiver Name (if applicable)

First NameLast Name
Parent/Guardian/Caregiver Phone Number (if applicable)
Please enter a valid phone number.
Relationship to Guest
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.
Parents and Caregivers of Special Guests are invited to enjoy a complimentary meal in the Respite Room. Of course, you are welcome to watch the Red Carpet event, Crowning Ceremony and participate in all the other events. Would you like to use the Respite Room during the event/
Accessibility & Support Needs
Does the guest require mobility assistance?

WheelchairWalkerAssistance WalkingNo Assistance Needed
Medical or Behavioral Information we should know (Seizures, anxiety triggers, elopement risk, etc...
Food Allergies or Dietary Restrictions
Sensory Sensitivities(check all that apply)

Loud musicBright lightsCrowdsTouchOther
If Other, please describe
Anything else you would like us to know about the guest?
Media & Photography Consent
I grant permission for photos/videos*
Liability & Medical Release
I authorize event organizers and medical personnel to provide emergency medical care if needed during Night to Shine and release LCC and volunteers from liability except in cases of gross negligence.*

Yes (sign below)Other
Signature*

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Night to Shine Attendee Registration

Guest Information

Caregiver/ Parent/ Guardian Information

Accessibility & Support Needs

Media & Photography Consent

Liability & Medical Release