Virtual Night to Shine Participant Registration Form The Night to Shine prom event is open to all people with special needs age 14 and over. Information will be sent later detailing how you connect to the virtual event and information about the Shine-Thru drive-thru event. Guest Information *First Name *Last Name *Address: street *Address: City *Address: State *Address: Zip code *Age *Gender FemaleMale T-shirt size (adult sizes): SMLXLXXLXXXL Event Responsible Person: *Relationship to guest (select one) ParentGuardianCaretakerOther *First Name *Last Name *Phone Number *Email Other Comments: Media Rights Release Click here to read the release and then check the box if you agree. I accept the terms of the media release statement Accident Waiver and Release of Liability Click here to read the release and then check the box if you agree. I accept the terms of the Accident Waiver and Liability form. Care Provider Agency Information - If Applicable Agency name: Agency address street: Agency address city: Agency address state: Agency address zip code: Agency contact first name: Contact last name: Contact email: Care Provider Agency Phone Royal Treatment Night to Shine is a night for the churches to shine, the volunteers to shine, our honored guests to shine, and most importantly, God to shine!