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Guest Registration

You're Registered!

We can't wait to celebrate with you on February 12, 2027!

Personal Information

First Name *

Last Name *

Date of Birth *

Phone

Address

Street Address

City

State

ZIP

Emergency Contact

Contact Name *

Contact Phone *

Event Details

Attending With (Caregiver/Parent)

How many will be enjoying the Respite Room?

The Respite Room is a quiet space for caregivers and family while guests enjoy the event.

Have you attended Night to Shine before?

Buddy Request

Special Needs / Accommodations

Medical Notes

Dress & Suit Boutique

We will be hosting a Dress & Suit Boutique prior to the event where guests may select something to wear. Date and location coming soon!

I am interested in a dress or suit from the Boutique. (We'll email you the date and location.)

Health & Accessibility

Fun Fact about the Guest

Health Concerns None / N/A

Wheelchair / Accessibility Needs None / N/A

Special Communication Needs None / N/A

Special Issues / Concerns None / N/A

Allergies None / N/A

Food / Dietary Needs None / N/A

Medication Needs None / N/A

Additional Information

Anything else we should know?

Consent & Acknowledgements

I understand that Night to Shine volunteers will not administer medication to guests and will not assist guests with bathroom usage. A caregiver, family member, or support person must be available to the guest for these needs. * I grant permission for photos and videos to be taken and used for Night to Shine and Tim Tebow Foundation promotional purposes.

Night to Shine

An unforgettable prom night experience, centered on God's love, for people with special needs ages 14 and older.

Event Details

Friday, February 12, 2027
6:00 PM – 9:00 PM
Trinity Lutheran Church
1546 N Luther Road
Fremont, NE