NTS Volunteer Registration - Under 18 Years Old

Night to Shine Volunteer Registration - Under 18 Years Old
Volunteer Information

Please ONLY use this form if the volunteer is under the age of 18.
Volunteer Name*
Volunteer Birth Date*

MonthDayYear
Date
Gender:*

MaleFemale
Parent/Guardian Information
Parent/Guardian Name*

First NameLast Name
I give permission for my child to volunteer at Night to Shine at Patrick Springs Pentecostal Holiness Church on February 13th, 2026*

YesNo
Emergency Contact Information
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Media Rights Release
By signing below, and for the good and valuable consideration of participating in an event hosted by Patrick Springs Pentecostal Holiness 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 Patrick Springs Pentecostal Holiness Church (“PSPHC”), a Virginia 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 PSPHC, 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 PSPHC, and to any benefits inuring to TTF and PSPHC as a result of its use of any of the foregoing recordings. Among other things, TTF and PSPHC 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 PSPHC, for the advancement of TTF and PSPHC’s exempt charitable purposes. All permissions granted herein extend to any successor or assign of TTF and PSPHC and bind me and my heirs, successors, and assigns. I, hereby release and discharge and agree to hold harmless TTF and PSPHC, 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.
I have read and agree to the statement above and give consent for my child to participate in Night to Shine.*

YesNo
We’ll be in touch with all registered volunteers via email as the event approaches. Keep an eye on your inbox for important updates and details!

You should receive a confirmation email once your registration is submitted. If you do not receive one, please contact Morgan Cockram (morgan.cockram@psphc.org) or Sydney Hopkins (sydney.hopkins@psphc.org).
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Night to Shine Volunteer Registration - Under 18 Years Old

Volunteer Information

Parent/Guardian Information

Emergency Contact Information

Media Rights Release