Attendee Registration

Attendee Information

Attendee's Full Name

Preferred Name

Phone

Address

Date of Birth

Age

Will the attendee be attending with a guest or date?

Yes No

Will the attendee need assistance from a caregiver or support person during the event?

Yes No Unsure at this time

Parent/Guardian & Emergency Contact

Parent/Guardian or Primary Contact Name

Relationship to Attendee

Phone

Emergency Contact Name

Emergency Contact Phone

Who is authorized to pick up the attendee at the end of the event?

Will a parent, guardian, or caregiver be attending the prom?

Yes No N/A

Accessibility & Dietary Needs

We want every attendee to feel comfortable, included, and supported throughout the evening. Please share any accommodations that may help us make this event enjoyable.

Does the attendee have accessibility or mobility needs?

Wheelchair accessibility Walker or other mobility aid Assistance navigating the venue No accommodations needed

Does the attendee have any sensory sensitivities?

Loud Music Flashing/Bright lights Crowds May need access to a quiet area None

Does the attendee have any communication or support needs?

Verbal Communication assistance Visual Communication Supports Additional Time/Assistance with Instructions None

Does the Attendee have any food allergies or dietary restrictions?

Yes No

Please specify food allergies or dietary restrictions.

Is there anything else our team should know to help the attendee have a safe and enjoyable evening?

Event Policies & Safety Acknowledgement

To help ensure a safe and enjoyable evening for everyone, please review the following event guidelines.

All attendees are expected to treat other guests, volunteers, and staff with kindness and respect.
Attendees and caregivers should follow event staff instructions and venue safety guidelines.
Parents, guardians, and caregivers should communicate any necessary support needs to even torganizers before the event.
Attendees ust follow the designated check-in and check-out procedures.
Only individuals authorized by the parent, guardian, or attendee (as applicable) may pick up an attendee.
Event organizers should be informed of any relevant safety concerns or support needs before the event.
Please contact the event organizers if your registration or attendance plans change.

Please select the statement that applies:

I have reviewed the event policies and understand the expectations for attending the Special Needs Prom I understand that I may contact the event organizers with questions or accommodation requests before the event

Thank you for registering! We cannot wait to celebrate with you and create a wonderful night filled with music, dancing, friendship, and unforgettable memories.

Attendee Registration

Description

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