Night To Shine 2021 Guest Registration

Please complete and submit to register as our guest for the Night to Shine event.
 
 
Please select all that apply.
 
 
 
 
*** Please note all further information and the link to the virtual event will be sent to the email address you provide.
 
 
Please select one option.
 
 
 
Please select one option.
 
 
 
Please select one option.
Please select one option.
Please select one option.
Please select one option.
 
 
 
 
 
Parent/Caretaker Information

 
 
Care Provider Agency - If Applicable

 
 
 
 
 
 
 
*** Please click on the links below to download the Participant Media Rights Release, Parent/Caretaker Media Rights, and Liability Release forms must be completed, and require a signature. Please download and print the form to return to Hope Church. If you are unable to print the form, please contact us so we can assist.***


Night To Shine Participant Media ReleaseĀ 

Night To Shine Parent:Caretaker Media ReleaseĀ 

Night To Shine Liability Release


Please fax, scan, mail, or bring forms to:

Hope Church
Atten: Kelsey Bolton
1118 Franklin Turnpike, Danville VA 24540


kelsey@ourhopechurch.com
Fax: (434) 836-5092

Description

Please complete and submit to register as our guest for the Night to Shine event.