Night to Shine 2025 SERVING MEALS TO GUESTS AND BUDDIES

First Name *

Last Name *

Email Address (used for event communication) *

Mobile Number (used for event communication) *

Gender *

Date of Birth *

If you have prior experience with people who have special needs, please explain.

If you would like to help in a way not listed above, let us know here.

Liability Release:

I assume all liability for my participation in Night to Shine 2025. I understand that Southern Hills, the Church at City Station and assume no liability or responsibility for anything that happens at Night to Shine 2025. Legally, this document says I am responsible for my actions at the event and I chose to abide by rules as part of this form.

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature. *