TC Dinner and a Show - Beauty & the Beast 2026

TC Dinner and a Show: Beauty & the Beast
Sunday, February 8

Time: 1:30pm - 6:00pm *Dinner will be after the show (4pm)
Redlands, CA

*CCF provides all meals, and transportation, if needed.

PLEASE REGISTER BY JANUARY 30, 2025 TO RESERVE YOUR SPOT.

Space is limited for those who would like to carpool with CCF. We will confirm availability once we receive your registration. Carpool will meet at the CCF Office in Loma Linda.
________________________________________________

Teen Connection is a life-affirming peer-support program by Childhood Cancer Foundation of Southern California for teenage cancer patients and survivors. Designed for youth ages 14–18, this program offers a safe, supportive space where teens can connect, socialize, and simply enjoy being teens together.

Through Teen Connection, participants meet with caring youth and adult facilitators to share experiences, build friendships, and find encouragement from others who truly understand their journey. All activities and events are provided free of charge to participants.

To learn more, visit ccfsocal.org/teen-connection

________________________________________________
Will your teen need transportation by CCF Staff?*

YesNo

CCF TRANSPORTATION
I understand that I must be at the CCFSC office by 1:30pm for DROP OFF & 6:00pm for PICK UP.*

Yes

PARENT TRANSPORTATION
I understand that I must be at LIFE HOUSE THEATER IN REDLANDS at 1:45pm for DROP OFF & at 5:45pm at DINNER LOCATION for PICK UP.*

Yes

PARENT PERMISSION SLIP

PERMISO DE PADRES
(TO BE COMPLETED BY PARENTS)
Teen Patient's Full Name*

First NameLast Name
Parent's Name*

First NameLast Name
Email*
example@example.com
Cell Phone Number*
Please enter a valid phone number.
May we send you text notifications?

YesNo
Emergency Contact Information #1*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relationship to Teen*
Relationship
Emergency Contact Information #2*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relationship to Teen*
Relationship
If someone other than the parent is picking up the patient, please provide the following information:
Name of person picking up teen
Name of person picking up my teen
Relationship to teen
Relation
Phone Number
Please enter a valid phone number.
I hereby authorize, person named above to pick up my teen
Parent Signature

Clear

Medications
Is your teen on any medication?*

YN
Will medication need to be taken during trip?*

YN
Is the teen able to administer own medication?

YN
If yes to medication, please let us know how often must they be administered?
Physical Limitations
Please indicate anything we should be aware of for the trip:*
Type N/A if there is nothing for us to be aware of.

TEEN AGREEMENT
Dinner and a Show - Redlands, CA

(1) I will remain with Teen Connection group throughout the entire trip and willingly participate in the activities.

(2) I understand that any bullying, name-calling, making fun of anyone in the group or outside the group, inappropriate language, behavior or dress WILL NOT BE TOLERATED. If the behavior is continuous and becomes a problem with the group, it will require prompt removal from future Teen Connection trips. Parents will be notified and asked to pick up the teen from the event location if the issue cannot be resolved during an event.

(3) I understand that all electronics including iPods, MP3 players, cell phones, etc. will remain put away and on silent while on the trip. Cell phones may only be used on emergency basis.

(4) Childhood Cancer Foundation of Southern California does not offer pick up or drop off options for teens at various locations along the route of the trip. Teens must have transportation to and from the office at the designated times.

(5) I understand that CCFSC will pay for meals and admission. I am responsible to bring spending money for souvenirs, snacks and other items I may want to purchase.

(6) Teen Connection accepts registration for events on first come basis. When registering for an event, be sure you can attend. If teen registers and cancels for an event it will be counted as a strike and each teen will only be allowed three strikes before being removed from future events.

Events requiring non-refundable pre-purchased tickets will be billed out to parents if teen does not attend.
Teen Signature*

Clear
Date*

MonthDayYear
Date

Parent Waiver / Agreement
Childhood Cancer Foundation of Southern California, Inc./Teen Connection Program accepts no responsibility for the loss, damage, or theft of your property. Furthermore, I hereby agree to waive, release and discharge any and all claims for damages, death, personal injury or property damage which I may have, or which may hereafter accrue to me as a result of participation in the Teen Connection Program Event. This release is intended to discharge in advance Childhood Cancer Foundation of Southern California, Inc./Teen Connection Program and any and all agents involved in the Teen Connection Program, from any and all liability, claims, costs, expenses and /or damages (collectively referred to as “liability”) arising out of or connected in any way with my participation in the activities of the Teen Connection, even though that liability may arise out of negligence or carelessness on the part of the persons or entities mentioned above. Additionally, I hereby authorize any employee and/or volunteer of Childhood Cancer Foundation of Southern California/Teen Connection Program to authorize transport for the purpose of providing emergency medical care to any medical facility and further empower to authorize medical treatment deemed necessary by a licensed physician for my health and safety of my child.
Parent Signature/Firma de Padre*

Clear
Should be Empty:

CCF TRANSPORTATION

PARENT TRANSPORTATION

PARENT PERMISSION SLIP

(TO BE COMPLETED BY PARENTS)

Medications

Physical Limitations

TEEN AGREEMENT

Parent Waiver / Agreement