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Joy Prom Registration Form

Please answer all questions below to register for the Joy Prom. The Joy Prom is for ages 13 and up and will be held Sunday, May 5th, 2019 from 5:00pm - 8:00pm at Calvary Baptist Church.

If attendee plans to bring a date/guest, he or she needs to fill out a separate registration form.

Save the date!

Closes in 44 days.

Attendee Name :

School or Group Home :

Home Address :

City :

Zip Code :

E-mail Address :

Phone :

Does attendee require a caregiver at the prom table? :
If yes, provide name of caregiver :

Hospitality Suite is an area where caregivers can wait for attendees and date/guests attending prom and enjoy hors d'oeuvres and desserts.
How many caregivers will enjoy the hospitality suite? :

At Joy Prom, professional photographers and videographers will capture all of the special moments. We need the permission of the parent/guardian to use the attendee’s likeness, name, voice and words in materials and promotions associated with Joy Prom including newsletters, websites, event video and other promotion associated with the event. Choose YES below if you give permission for the attendee named above to have his/her photograph used in any materials and promotions associated with the Joy Prom.

We will have a medical team present.
I give consent :

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Calvary Baptist Church • 901 Montezuma Ave • Dothan, AL 36303  • 334-792-5159 . fax: 334-792-3061