Guest Registration: Night to Shine Prom 2024
Registration for guests attending Night to Shine Prom on Friday Feb 9 2023 @ 6pm @ Valley Pathways School, 1150 France Rd. Palmer, AK. (We will have many of the same activities / stations available as we did at Raven Hall last year.)

Please email office@palmernaz.org with any questions! 

(*Any guests registering Feb 8 + 9th may not receive a gift bag)

Can't wait for an awesome time at Night to Shine 2024!
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Email *
Full name of Guest *
Full Name of Person Completing this form (if different than guest)
Best Contact Number *
Address (Optional)
Age (all attendees must be over 14 years old) *
Gender
Please tell us more about you/ the guest and any fun facts about you/the guest!  *
Have you attended Night to Shine previously?
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Allergies? (List any that apply: foods, animals, latex, makeup, plants or pollen etc) **(Food + Drinks will be provided at the event)**
Special Communication needs?
Would you/guest prefer entering through side entrance of building rather than through the paparazzi? 
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Would you like an email link with the information to the Virtual Celebration?
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Parent / Caretaker Full Name *
Contact Phone for Parent / Caretaker *
Email for Parent/ Caretaker *
Any parents / caregivers attending with the guest? If so, how many? 
Media Rights Release
I have read and agree to the media rights release. *
Release of Liability page 1
Release of Liability page 2
I have read and agree to the liability release *
By typing in my name below I am agreeing to the above releases that I have selected "yes, I have read and agree". If I am a minor under 18 years of age, my parent / caretaker must sign below. *
Additional comments / questions, etc.
A copy of your responses will be emailed to the address you provided.
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