Los Angeles Prom 2016

Please Help Make the No Worries Now Prom Possible!

Please consider donating to make the No Worries Now Prom possible! We are an all-volunteer nonprofit organization and rely entirely on donations in order to throw these proms. One-hundred percent of your donation goes directly to putting on the No Worries Now prom. Click the button to donate!

RSVP for the No Worries Now Los Angeles Prom 2016!

Name*

Email*

Phone Number*

Full Address*

Age*

Hospital/Organization*

Illness*

Emergency Contact Name*

Emergency Contact Phone*

Emergency Contact E-mail*

Emergency Contact Relationship to You*

Do you have any special circumstances you would like to notify us about?

If you are over 18, please type your name in the box below to acknowledge that you have read, understand, and agree to No Worries Now's "Consent to Be Photographed/Videotaped; Authorization for Use or Disclosure," available at http://noworriesnow.org/wp-content/uploads/2016/04/No-Worries-Now-Release.pdf. If you are under 18, please ask a parent or guardian to read the form and type his or her name below to acknowledge that he or she has read, understands, and agrees to the consent form.*

Each patient may bring one guest. Only guests who have RSVP'd will be admitted.

Guest Name

Guest Email

Guest Age

Guest Relationship to You

Please tell us how you heard about No Worries Now*:

Have you attended past No Worries Now Proms? If so, in what year(s)?*


Most attendees support No Worries Now by making a donation or by buying a pair of No Worries Now sunglasses for $15 per pair or $25 for 2 pairs. If you buy a pair of sunglasses online, they will be waiting for you at the No Worries Now Prom. Once you have submitted this form, go to http://noworriesnow.org/get-involved/donate/ to support No Worries Now and get an awesome pair of sunglasses!

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