Student Hosts

Student Host Registration WAITING LIST – 2018

For students ages 15-22 who wish to host an honored guest to the Prom.

Step 1 of 4

25%

This is my/my students first time being a Host*
- Yes
- No
Parent Name*

First

Last
Parent Email*

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Parent Phone*

Student Host Information
Name*

First

Last
Email*

Enter Email

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Mobile Phone*
Address*

Street Address

Address Line 2

City

ZIP Code
Date of Birth*
Based on the Date of Birth you provided, this student falls outside the age requirements for the prom.
Gender*
- Male
- Female
School*
Other*

Acknoweldgments and Releases
TRANSPORTATION, EVENT, PHOTOGRAPH AND VIDEO RELEASE*
I have investigated the risks involved in the Honored Guest’s participation in A Night to Remember Prom and fully understand and assume such risks on his/her behalf. Specifically, I understand and acknowledge that the Honored Guest/Host may suffer or experience, among other things, personal injury or bodily damage, medical disabilities, and loss or theft of personal property As parent and/or legal guardian of the named Honored Guest/Host, I request that EastLake Church, The Arc of San Diego & ANTR Prom allow the Honored Guest/Host to participate in the activities associated with A Night to Remember, and in consideration thereof agree hereby to release and forever discharge EastLake Church, The Arc of San Diego & ANTR Prom, its employees, agents and any parties volunteering, from all actions, cause of action, injuries, claims, damages, costs or expenses of any kind, including any negligence of the church, growing out of or related to the activities (including transportation to and from the activities) in which the Honored Guest/Host participates. I understand that this a full and complete release of all injuries and damages which the Honored Guest/Host may sustain as a result of his/her participation in the activities, regardless of the specific cause thereof.
- This agreement is binding on my heirs, successors and personal representatives.
PHOTOGRAPH & VIDEO CONSENT AND RELEASE*
In consideration of participating in the above-referenced Activities, I give EastLake Church, The Arc of San Diego & ANTR Prom permission to use the Honored Guest/Hosts name, likeness, image, voice, and/or appearance in pictures, photos, video recordings, audiotapes, digital images, and the like (collectively “material”), whenever taken or made for use in multi-media or printed presentations and used for display during services, events, or on A Night To Remember’s website, or incorporated in non-commercial or commercial products and services or A Night To Remember related products or services. I agree that A Night to Remember has complete ownership of such material including the entire copyright. These uses also include, but are not limited to DVDs, exhibitions, videos, reprints, publications, advertisements, and other promotional, commercial, or educational materials in any medium including the Internet. I acknowledge that I or the Honored Guest/Host will not receive any compensation for the use of such material and hereby release A Night to Remember, and its agents and assigns, from any and all claims that arise out of or are in any way connected with such use, including, without limitations, from any liability for violation of rights of privacy, publicity, defamation or any similar right.
- This agreement is binding on my heirs, successors and personal representatives.
PERMISSION FOR MEDICAL TREATMENT AND POWER OF ATTORNEY*
In the event the Honored Guest/Host suffers an injury or condition during his/her participation in the Activities, including transportation to and from the Activities, which may endanger his/her life, cause disfigurement, physical impairment or undue discomfort if medical treatment is delayed, and reasonable attempts to contact me or the designated alternate contact person have been unsuccessful, to the extent allowed by local law, I hereby appoint the attending EastLake Church, The Arc of San Diego & ANTR Prom staff member or agent, as the Honored Guest’s/Hosts agent to act for them and in my name (in any way I could act in person) to make any and all decisions for the Honored Guest/Host concerning his/her personal care, medical treatment, hospitalization and health care. This power of attorney and delegation of authority shall terminate when the agent is able to contact me or the designated alternate contact person.
- This agreement is binding on my heirs, successors and personal representatives.

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FAQ's

What do I wear?

You need to arrive dressed in a nice dress with your hair & make-up done…ready to serve as a Host.

Guys – shirt & slacks – no jeans! (tie optional)
Girls – a dress - it can be your Prom dress…as long as it’s not inappropriate (meaning not too short & too tight).

**If you are dressed inappropriately, you will be sent home and not be permitted to serve**

Remember, this night is about our HONORED GUESTS. You do not want to be a distraction in ANY way from THEIR night. This is not your Prom.

What do I do when I arrive?

You will be partnered up as the “Host/buddy” for a specific Honored Guest. (We generally try to partner guys with guys; girls with girls).

You will be by their side THE ENTIRE EVENING, from 6 pm until 9 pm.

What does being their HOST look like?

You will be next to your Honored Guest when they get their make-up/hair, you will go with them to pick out jewelry, you will go with them as they get their corsage/boutonniere, you will go with them as they get their picture taken (and you will be in a picture with them), you will go with them in the Limos, you will walk the Red Carpet with them, you will dance with them, eat with them (help get their food), introduce them to other Guests. You sole responsibility is to serve the Honored Guest and make them feel loved, honored, accepted and celebrated. This is a very special night for them, and you are a BIG part of it. And we expect that once it’s over, you will also consider it a special night for you too.

What are the ages to be a host?

Student Hosts must be between the ages of 15-22. Help us spread the word and be sure to sign up as a Host when Registration opens Mar. 1st.

Thanks for being willing to partner with us! It truly will be “A Night to Remember”!

Student Hosts

Student Host Registration WAITING LIST – 2018

Step 1 of 4

Student Host Information

Acknoweldgments and Releases

Confirm Entered Information

FAQ's

What do I wear?

What do I do when I arrive?

What does being their HOST look like?

What are the ages to be a host?

About A Night to Remember

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