Night to Shine 2020 Guest Registration
  • Night to Shine 2020 Guest Registration

  • We are excited to have you attend Night to Shine 2020! The event will be held on Friday, February, 7th from 6-9 pm at Oak Mountain Presbyterian Church in Birmingham, AL. The night includes a red carpet walk, dinner, dancing, karaoke, limo rides and more! Each guest will be assigned a buddy for the evening. If you would like a family member, friend or caregiver to be the guest's buddy, that individual MUST visit our website and complete the registration for a volunteer, complete a background check and attend one of our three training sessions. To make sure each guest has the night of their life, please take a moment to fill out the registration form completely, giving us as much information as you can about the guest's needs. If you have any questions, please email us at ntsbirmingham@gmail.com.

  • Date of Birth*
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  • Sex*
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  • Parent and Caregiver Information


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  • Parents/Caregivers-we have a very special area just for YOU!! You are welcome to stay and enjoy some time to yourself or with your spouse!  We will have a catered dinner, live music, complimentary beauty services, give-a-ways and live feeds in each area for watching the prom fesivities. 

  • Will parent/caregiver be staying onsite during Night to Shine and attending the Parent/Caregiver room?*
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  • Will this emergency contact be picking the guest up at the conclusion of the event?*
  • Guest's Dietary Information

  • Dinner will be provided at the event. Menu includes: Water, Lemonade, Cheese & Pepperoni Pizza, Chick-Fil-A Fried & Grilled Nuggets, Fruit, Chips and Assorted Desserts (no nuts or peanut butter). There will be alternative Vegetarian, Dairy Free, Gluten Free, Sugar Free options. Please indicate dietary restrictions below:

  • Does the guest require special dietary requirements?*
  • Please select all dietary requirements that are needed?*

  • Guest's Medical Information

  • Motor Impairment*
  • Vision Impairment*
  • Heart Concerns*
  • Seizures*
  • Allergies (other than food, i.e. latex, make-up, etc.)*
  • Sensory Concerns (flashing lights, loud noises, etc)*
  • Would your guest benefit from a sensory kit provided by KultureCity supplied with noise-cancelling headphones and other items?*
  • Asthma*
  • Which statement best describes the guest's method of communication*

  • Would it be helpful to have a visual schedule of events and activities for the guest?*
  • Does the guest have a tendency to elope?
  • Has the Guest ever attended any event with one of these organizations?*

  • Group Care Information

  • Will guest be arriving as part of a group that will require group check in?*
  • Will the guest have a caregiver as a pre-assigned buddy coming with them from the organization?*
  • The Fun Stuff!

  • T-Shirt Size*
  • We will be offering complimentary opportunities for the ladies to have their hair and makeup done prior to the event. Please indicate if you are interested in using this service and would like more information.*
  • Guest Media Release

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  • Media Release: By signing below, and for the good and valuable consideration of participating in an event hosted by Oak Mountain Presbyterian 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 Oak Mountain Presbyterian Church (“CHURCH”), a VA 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 recording or use of the 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 and for above registered participant.

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