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Wait List - Guest Registration

Guest Registration is Full! But there are still some options for you.

  1. If you're interested is being added to the Wait List, please register below and you will be contacted if there is a cancellation.
  2. There are also other Night to Shine events in the area that will take place on February 9, 2018. Visit www.nighttoshineohio.com for a listing of other venues and contact them directly for registration options.

 

Wait list registration form

All fields are mandatory. If not applicable, please type N/A

***A media request form will be requested for all guests***

Guest information
Name of Guest *
Name of Guest
Address *
Address
All Fields Are Required
Phone *
Phone
Emergency Contact Person *
Emergency Contact Person
Phone (Emergency Contact Person) *
Phone (Emergency Contact Person)
Gluten Free, pureed/cut up food, etc.
Sensitivity to Loud Noises, crowds, tactile responses
Parent/Caregiver Information
Parent/Caregiver Phone *
Parent/Caregiver Phone
Parent/Caregiver will be: *
Care Provider Agency Information (if Applicable)
Agency Phone
Agency Phone