Grays Harbor Foursquare Church - Night to Shine Guest Registration

Night to Shine Guest Registration

Night to Shine is an unforgettable worldwide celebration event, centered on God's love, honoring and valuing people with special needs. This event is hosted each year on the Friday before Valentine's Day by churches across the globe, bringing congregations, communities, and families living with disability closer together in fellowship.

The Body of Christ is not complete without people with disabilities. People with disabilities are our Kings and Queens because God sees them as royalty and so should we.

This event is open for anyone who lives with special needs and are 14+ years old.

GUEST INFORMATION

First Name

Last Name

Name as you would like it to appear on Nametag:

Fun Fact About You

Date of Birth

Gender

Male

Female

Phone Number

Email

Address

Apartment, suite, etc.

City

State

Postal / Zip Code

Emergency Contact During Event

Emergency Contact Phone Number

TRANSPORTATION

Will guest be dropped off and picked up by parent / caretaker?

Yes

No

Will guest be taking public transportation to and from event?

Yes

No

If yes, please list below

Will guest be attending as a part of a group that will provide transportation?

Yes

No

If yes, please list Group and Contact Information below

For our guests, comfort and safety is our number one priority. Having the most accurate information is critical to ensure a seamless experience for them. If our Guest's transportation changes, we kindly request that you contact us as soon as possible.

MEDICAL

Please note that the church, their staff, and volunteers are not responsible for administering medication to guests during the Night to Shine event. If medication is required during the event, a parent or caretaker MUST be available to administer the medication.

Will Guest need medication administered during the event?

Yes

No

We would love to make your Night to Shine experience the best it can possibly be. If you are comfortable sharing, please answer any of the following items that apply in order to help us offer the best support we can.

Health Concerns

Mobility Needs

Communication Needs

Sensory Issues / Concerns

Allergies

Food Needs

Additional Notes / Concerns you would like us to be aware of?

Do you wish to be paired with a specific Buddy that will be Volunteering?

What is your relationship with them?

Please note - We will do our best to accommodate your request but we cannot guarantee it.

If your Spouse does not live with special needs and would like to be your Buddy for the evening, please have them register as a Volunteer and list you as their requested Guest.

CARETAKER INFORMATION

First Name

Last Name

Phone Number

Email

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Relationship to Guest

Caretaker will be

Dropping Guest Off

Enjoying the Respite Room

The Respite Room is a private area where caretakers of guests can spend the evening enjoying food, entertainment, and rest while remaining onsite during the event.

If enjoying Respite Room, please list Caretakers

Name #1

Name #2

CARE PROVIDER AGENCY INFORMATION - IF APPLICABLE

Care Provider Agency

Agency Phone Number

Agency Chaperone - if applicable

Chaperone Phone Number

Note: Chaperone is not required to stay with guest(s) unless required by Care Provider Agency. If Chaperone remains with guest, a current Background Check will be required.

Any Additional Notes or Concerns

Our priority is to make this event as comfortable as possible for our guests. Any additional information is appreciated.

NIGHT TO SHINE - PARTICIPANT
MEDIA RIGHTS RELEASE FORM
(Guests, Volunteers & Vendors)

By signing below, and for the good and valuable consideration of participating in an event hosted by Grays Harbor Foursquare 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 Grays Harbor Foursquare Church (“GHFC”), a Washington 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 GHFC, 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 GHFC, and to any benefits inuring to TTF and GHFC as a result of its use of any of the foregoing recordings. Among other things, TTF and GHFC 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 GHFC, for the advancement of TTF and GHFC’s exempt charitable purposes. All permissions granted herein extend to any successor or assign of TTF and GHFC and bind me and my heirs, successors, and assigns. I, hereby release and discharge and agree to hold harmless TTF and GHFC, 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 an option

By signing below, you agree that you are over the age of 18 and that you consent to the text above:

Signature of Parent / Caretaker / Guardian (if participant is under 18)

Parent / Caretaker / Guardian - Name, phone number, email address

NIGHT TO SHINE - PARENT/CARETAKER
MEDIA RIGHTS RELEASE FORM

By signing below, and for the good and valuable consideration of participating in an event hosted by Grays Harbor Foursquare 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 Grays Harbor Foursquare Church (“GHFC”), a Washington 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 GHFC, 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 GHFC, and to any benefits inuring to TTF and GHFC as a result of its use of any of the foregoing recordings. Among other things, TTF and GHFC 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 GHFC, for the advancement of TTF and GHFC’s exempt charitable purposes. All permissions granted herein extend to any successor or assign of TTF and GHFC and bind me and my heirs, successors, and assigns. I, hereby release and discharge and agree to hold harmless TTF and GHFC, 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 an option

By signing below, you agree that you are over the age of 18 and that you consent to the text above:

Almost Done!

By signing this form you agree that the above information is true and correct to the best of your knowledge, and that you consent for our NTS Team to contact you in regards to this event.

Guest Signature

Parent / Caregiver Signature

Night to Shine Guest Registration

NIGHT TO SHINE - PARTICIPANT
MEDIA RIGHTS RELEASE FORM
(Guests, Volunteers & Vendors)

NIGHT TO SHINE - PARENT/CARETAKER
MEDIA RIGHTS RELEASE FORM

Almost Done!

Hebrews 13:8

Service Time

Office Hours

Contact Info

Follow Us

Night to Shine Guest Registration

NIGHT TO SHINE - PARTICIPANT MEDIA RIGHTS RELEASE FORM(Guests, Volunteers & Vendors)

NIGHT TO SHINE - PARENT/CARETAKER MEDIA RIGHTS RELEASE FORM

Almost Done!

Hebrews 13:8

Service Time

Office Hours

Contact Info

Follow Us

NIGHT TO SHINE - PARTICIPANT
MEDIA RIGHTS RELEASE FORM
(Guests, Volunteers & Vendors)

NIGHT TO SHINE - PARENT/CARETAKER
MEDIA RIGHTS RELEASE FORM