NTS 2026 Guest Registration

Guest Name

Last NameFirst Name

Guest Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Guest Phone Number

Please enter a valid phone number.

Age of Guest

Gender of Guest

MaleFemale

Email Address for Primary Communication

Emergency Contact

Last NameFirst Name

Relationship to Guest

Emergency Contact Phone Number

Please enter a valid phone number.

Guest Health Concerns/Other Info We Need To Know

Guest Mobility Needs/Wheelchair

YesNo

Guest Food Allergies/Concerns

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.

One Fun Fact About the Guest to be announced on the Red Carpet.

Is the Guest coming with a specific Buddy for the evening?

YesNo

Name of Buddy

All Buddies must register as a volunteer and have a background check, even family members who plan to be buddies.

Night to Shine Media Rights Release

By signing below, and for the good and valuable consideration of participating in an event hosted by First Baptist Church Lake Wales (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 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:

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First Baptist Church Lake Wales Liability Release

I understand that by signing below, I assume any risk of harm or injury that may occur to the participant due to his/her/my participation in the event or activity. If the participant is a minor, I agree that I have given my consent for the minor to participate in the event. I further provide my consent for First Baptist Church of Lake Wales to seek emergency treatment for the participant, if necessary. I agree to accept financial responsibility for the costs related to any necessary emergency treatment. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless First Baptist Church of Lake Wales, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: The First Baptist Church of Lake Wales, the activity holders, sponsors, and volunteers. I further acknowledge that the First Baptist Church of Lake Wales are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf or on the activity premises and herein agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions remain in full force and effect.

I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT, AND I AGREE TO IT OF MY OWN FREE WILL.

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