• HONORED GUEST

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Medication Disclaimer

    * 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.

  • 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 optional items that apply in order to help us offer the best support we can.

  • Format: (000) 000-0000.
  • Parent/Guardian/Caretaker will be:*
  • Meet Buddy 

    *Please note parent/guardian/caretaker are required to meet assigned buddy/chaperone during registration.

  • Respite

    * The Respite Room is a private area onsite where parent/guardian/caretaker can spend the evening enjoying food, entertainment, and rest.

    Care Provider Agency Information - If Applicable

    (If attending as a part of a group, please include agency or company name)

  • Format: (000) 000-0000.
  • ASSUMPTION OF RISK, LIABILITY RELEASE, HOLD HARMLESS, AND MEDIA USE AGREEMENT

    Assumption of Risk, Release of Liability, and Hold Harmless Agreement
    I am of full age or a parent or legal guardian and have the right to contract in my own name or for a person under the age of 18. I understand and acknowledge that my participation, or the participation of the individual for whom I am legally authorized to sign to participate in the Night to Shine event hosted by Faith Temple of Christ and associated with the Tim Tebow Foundation is voluntary. I recognize that participation may involve certain risks, including but not limited to accidental injury, illness, falls, allergic reactions, medical emergencies, property damage, other harm, or unforeseen incidents or circumstances. I voluntarily assume the ordinary risks associated with participation in this event, whether attending as an honored guest, participant, volunteer, or other authorized attendee. To the fullest extent permitted by applicable law, I hereby release, waive, and discharge Faith Temple of Christ, the Tim Tebow Foundation, Inc., and their respective directors, officers, employees, representatives, volunteers, agents, and independent contractors from claims arising out of accidental injury, illness, property damage, other harm, or unforeseen circumstances or incidents associated with participation in the event, including claims arising from ordinary negligence, but excluding claims that cannot be legally waived. I further agree, to the extent permitted by applicable law, not to hold the above-named organizations or individuals legally responsible for such released claims. I understand that Faith Temple of Christ and the Tim Tebow Foundation cannot guarantee that the event will be free from all risks or that injuries or unforeseen incidents or circumstances will not occur. Nothing in this agreement releases any party from liability for gross negligence, reckless conduct, intentional misconduct, or any other liability that cannot be lawfully waived.

    Emergency Medical Authorization & Release
    In the event of an emergency, I authorize Faith Temple of Christ and its designated event representatives to contact emergency medical services and seek appropriate emergency assistance for me or the individual for whom I am legally authorized to make such decisions. I understand that Faith Temple of Christ and the Tim Tebow Foundation do not provide medical insurance coverage for participants or volunteers and that I remain responsible for medical expenses to the extent permitted by law.

    Media Use Release Agreement
    For the good and valuable consideration of participating in an event hosted by Faith Temple of Christ, 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 Faith Temple of Christ, an Indiana nonprofit organization, 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 Faith Temple of Christ, 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 Faith Temple of Christ, and to any benefits inuring to TTF and Faith Temple of Christ as a result of its use of any of the foregoing recordings. Among other things, TTF and Faith Temple of Christ 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 Faith Temple of Christ, for the advancement of TTF and Faith Temple of Christ’s exempt charitable purposes. All permissions granted herein extend to any successor or assigns of TTF and Faith Temple of Christ and bind me and my heirs, successors, and assigns. I, hereby release and discharge and agree to hold harmless TTF and Faith Temple of Christ, 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 States of Florida and Indiana, and should any provision of this release be determined invalid, such invalidity does not affect any of the remaining provisions.

    Acknowledgement, Agreement & Release
    By signing below, I acknowledge that I have read, understood and agree to the Assumption of Risk, Release of Liability, and Hold Harmless Agreement, in addition to the Media Use Release Agreement. I understand that participation in Night to Shine is voluntary.
    I understand that participation may involve certain risks, including accidental injury, illness, property damage, other harm, or unforeseen incidents or circumstances. I understand that this agreement may limit my legal rights, including the right to bring certain claims. I voluntarily agree to the terms of the Assumption of Risk, Liability Release, Hold Harmless and Media Use Agreement.

     

  • SAVE THE DATE

    Feburary 12, 2027 @7PM-10PM

    Faith Temple of Christ

    7601 Whitcomb St

    46410

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