February 8, 2019
Pre Prom: 5:00 - 6:00 PM
Dinner, Dance & Crowning*: 6:00 - 9:00 PM
Christ Lutheran Church
4325 Sumner St
Lincoln, NE 68506
*Caregivers join us at 8:30 PM for the last dance, crowning and a group photo.
Countdown to Night to Shine!
Attendance is limited to the first 100 guests. Guests registered after that will be put on a waiting list.
Thanks for filling out this form for our guest! We would like a little more information about you as well so we can have a more complete picture of your guest. It will also help us make sure all communications are as effective as possible.
Due to regulations, all buddies will need to be at least 16 years old. If you will be bringing your own buddy for the evening, we need the following information about THAT person. In order to ensure everyone's safety at Night to Shine, we will need to contact all buddies for a free background check prior to the event.
If you do not know your buddy's contact information, we ask that you please find out that information BEFORE submitting an application. We rely on all information being accurate. Thank you!
Our Guest Menu is: Raising Canes Chicken, Baked Potato, Green Beans, and a Homemade Dinner Roll. For dessert, we will have Kona Ice.
WAIVER AND RELEASE OF ALL CLAIMS FOR CHRIST LUTHERAN CHURCH GUESTS
Please read this form carefully and be aware that in attending as a guest, you will be waiving and releasing all claims for injuries you might sustain arising out of this participation.
As a guest in this program, I recognize and acknowledge that there are certain risks of physical injury and I agree to assume the full risk of any injuries, damages or loss which I may sustain as a result of participating in any and all activities connected with or associated with this program.
| agree to waive and relinquish all claims I may have as a result of participating in this program against Christ Lutheran Church (aka- Christ Lincoln) and their Pastors, staff, leadership, volunteers, and employees.
I do hereby fully release and discharge Christ Lutheran Church and their Pastors, staff, leadership, volunteers, and employees from any and all claims for injuries, damage or loss which I may have or which may accrue to me on account of participation in this program. I have read and understand the above Waiver and Release of All Claims.
Photo Consent and Release Form
Without expectation of compensation or other remuneration, now or in the future, I hereby give my consent to Christ Lutheran Church (aka-Christ Lincoln), its affiliates and agents, to use my image and likeness and/or any interview statements from me in its publications, advertising or other media activities (including the Internet). This consent includes, but is not limited to:
a. Permission to interview, film, photograph, tape, or otherwise make a video reproduction of me and/or record my voice;
b. Permission to use my name;
c. Permission to use quotes from the interview(s) (or excerpts of such quotes), the film, photograph(s), tape(s) or reproduction(s) of me, and/or recording of my voice, in part or in whole, in its publications, in newspapers, magazines and other print media, on television, radio and electronic media (including the Internet), in theatrical media and/or in mailings for educational and awareness.
Please only click the submit button once. Thank you!