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Night to Shine Guest Registration 2027

- Guests: This night is all about you. You are cherished. You are celebrated. You are wonderfully made. Night to Shine exists because you deserve an evening where the world pauses to honor your strength, your joy, your kindness, and the light you bring to everyone around you.
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  Guest Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth (Must be 14 by February 7, 2027) REQUIRED Please fill out this field. Please enter a date.
  
  Age Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Fun Fact about you (Guest): REQUIRED Please fill out this field. Please enter valid data.
  
  What is the guest’s favorite song for Karaoke and the DJ? Please enter valid data.
  
  Health Concerns: Please enter valid data.
  
  Special Communication Needs: REQUIRED Please fill out this field.
  
  Sensory Issues/Concerns (strobe lights, camera flashes, loud noises, etc.): REQUIRED Please fill out this field.
  
  If yes, please explain: Please enter valid data.
  
  Allergies (Please list any that apply: foods, animals, latex, makeup, plants or pollen, etc.): REQUIRED Please fill out this field.
  
  If yes, please list allergies: Please enter valid data.
  
  Is the Guest able to use the restroom by themselves? (If they cannot, a parent or caretaker will remain on site in Parent Room to assist in bathroom care, since none of our volunteers will be permitted to render aid for this).. REQUIRED Yes No Please fill out this field.
  
  Is there anything we can be praying about for you?
  
  Parent/Caretaker Information
  
  Parent/Caretaker Name: REQUIRED Please fill out this field. Please enter valid data.
  
  Please choose one: REQUIRED I will be the buddy to my registered guest. I will stay in the caregivers room I will drop off and pick up at 9:00 pm. Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Parent/Caregiver Phone Number REQUIRED
  
  Please fill out this field. Please enter a phone number.
  
  Will you be bringing a buddy/escort (other than the parent) to stay with you at the event? Reminder: Only 1 buddy allowed per guest due to Tiim Tebow Foundation regulations. REQUIRED Yes (please complete name and info below) No Please fill out this field.
  
  If yes, please complete buddy info below:
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Email Please enter an email address.
  
  Phone Number
  
  Please enter a phone number.
  
  Care Provider Agency Information - If Applicable
  
  Care Provider Agency: (If attending as a part of a group, please include agency or company name) Please enter valid data.
  
  Care Provider Agency Contact Phone Number
  
  Please enter a phone number.
  
  Name of Agency Chaperone (if applicable) Please enter valid data.
  
  Additional Notes or Concerns:
  
  Participant Media Release (Parent/Caretaker sign if participant under 18)
  
  By signing below, and for the good and valuable consideration of participating in an event hosted by St Luke Catholic Church, and sponsored in part by or associated with the Tim Tebow Foundation, I hereby give my full consent to Tim Tebow Foundation, Inc., (“TTF”) a Georgia nonprofit corporation headquartered in Florida and St. Luke Catholic Church (“CHURCH”), a STATE nonprofit corporation, to record, by writing, by video, photographic, or audio recording device, or by any other analog or digital means, my actions, physical likeness, biographical information, and/or voice. Additionally, I hereby grant to TTF and CHURCH, without royalty or other compensation now or in the future, all rights of every kind and character whatsoever, in perpetuity, in and to any and all such recordings, along with any additional recordings I might provide to TTF and CHURCH, and to any benefits inuring to TTF and CHURCH as a result of its use of any of the foregoing recordings. Among other things, TTF and CHURCH may, but are not required to, copy or reproduce the recording, edit or modify it, incorporate it into another work, display or broadcast it or any of the foregoing privately or publicly, and use or license it or any of the foregoing for use by others, all for the sole benefit and at the sole discretion of TTF and CHURCH, for the advancement of TTF and CHURCH’s exempt charitable purposes. All permissions granted herein extend to any successor or assign of TTF and CHURCH and bind me and my heirs, successors, and assigns. I, hereby release and discharge and agree to hold harmless TTF and CHURCH, its directors, officers, employees, volunteers, and independent contractors, from any and all claims or damages, including but not limited to defamation or violation of rights of privacy or publicity, arising from or associated with the recordings or use of recordings. This release shall be construed, interpreted and governed in accordance with the laws of the State of Florida, and should any provision of this release be determined invalid, such invalidity does not affect any of the remaining provisions. I am of full age and have the right to contract in my own name.
  AGREED TO AND ACCEPTED Please select this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date REQUIRED Please fill out this field. Please enter a date.
  
  Signature of Participant (if over 18) Please enter valid data.
  
  Signature of Parent/Caretaker (if participant is under age 18) Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City/State/Zip Please enter valid data.
  
  Phone Number REQUIRED
  
  Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter valid data.
  
  Parent/Caretaker Media Release
  
  By signing below, and for the good and valuable consideration of participating in an event hosted by St. Luke Catholic Church, and sponsored in part by or associated with the Tim Tebow Foundation, I hereby give my full consent to Tim Tebow Foundation, Inc., (“TTF”) a Georgia nonprofit corporation headquartered in Florida and St. Luke Catholic Church (“CHURCH”), a STATE nonprofit corporation, to record, by writing, by video, photographic, or audio recording device, or by any other analog or digital means, my actions, physical likeness, biographical information, and/or voice. Additionally, I hereby grant to TTF and CHURCH, without royalty or other compensation now or in the future, all rights of every kind and character whatsoever, in perpetuity, in and to any and all such recordings, along with any additional recordings I might provide to TTF and CHURCH, and to any benefits inuring to TTF and CHURCH as a result of its use of any of the foregoing recordings. Among other things, TTF and CHURCH may, but are not required to, copy or reproduce the recording, edit or modify it, incorporate it into another work, display or broadcast it or any of the foregoing privately or publicly, and use or license it or any of the foregoing for use by others, all for the sole benefit and at the sole discretion of TTF and CHURCH, for the advancement of TTF and CHURCH’s exempt charitable purposes. All permissions granted herein extend to any successor or assign of TTF and CHURCH and bind me and my heirs, successors, and assigns. I, hereby release and discharge and agree to hold harmless TTF and CHURCH, its directors, officers, employees, volunteers, and independent contractors, from any and all claims or damages, including but not limited to defamation or violation of rights of privacy or publicity, arising from or associated with the recordings or use of recordings. This release shall be construed, interpreted and governed in accordance with the laws of the State of Florida, and should any provision of this release be determined invalid, such invalidity does not affect any of the remaining provisions. I am of full age and have the right to contract in my own name.
  AGREED TO AND ACCEPTED Please select this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date REQUIRED Please fill out this field. Please enter a date.
  
  Signature of Parent/Caretaker Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City/State/Zip REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED
  
  Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter valid data.
  
  Name of Participant: Please enter valid data.
  
  Submit
- **Registration ends on January 20, 2027 or sooner if we reach capacity.**
  
  IMPORTANT:
  
  Parents and caregivers are welcome to relax in the designated Parent Room during the event. Event areas are reserved for registered guests and authorized volunteers; parents and caregivers may not enter these areas.
  Thank you for respecting this boundary. Anyone who does not follow this policy after a reminder will be required to leave the property.