Student Host Sign-Up

Student Hosts must be between the ages of 15 and 25 and are a buddy to an Honored Guest.

ALL Hosts must attend a Disability Training on April 28th from 2pm to 5pm.


  • No experience is required, just asking!
  • If you do not attend school, write "None".
    If other, we will contact you.
  • I have investigated the risks involved in the Honored Guest’s/Hosts participation in An Evening To Treasure 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 An Evening To Treasure and Northpointe Community Church (collectively “Sponsors”) allow the Honored Guest/Host to participate in the activities associated with An Evening To Treasure Prom, and in consideration thereof agree hereby to release and forever discharge all Sponsors, their employees, agents and any parties volunteering or sponsoring or donating, 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.
  • In consideration of participating in the above-referenced Activities, I give An Evening To Treasure and Northpointe Community Church (collectively “Sponsors”) 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 Sponsors’ websites, or incorporated in non-commercial or commercial products and services or prom Sponsors’ related products or services. I agree that Sponsors 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 Sponsors, 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.
  • 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 An Evening To Treasure or Northpointe Community Church 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.