* Individual completing this registration is: Select one Myself Parent/Caregiver Provider SSA Other
Has this guest attended this Night To Shine event before? Select one Yes No
* Emergency Contact Name & Number
* Specific Health Concerns for us to be aware of during the event
* Does this guest use a wheelchair? Select one No Yes
* Does this guest have Special Communication Needs? If so, please explain.
Does this guest have any Sensory Issues/Concerns (strobe lights, camera flashes, loud noises, etc.)?
* Does this guest have any issues or concerns in regards to using the restroom? If so, please explain.
Guest Allergies: Please list any that apply (food, latex, make-up, etc.)
* Food Needs: Does this guest need any food cut up, pureed, gluten free, etc.? If yes please explain.
Medication Information - Please note that Troy Christian 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.
PARENT/CARETAKER INFORMATION: - Information about the parent or caretaker of our guest.
Parent/Caretaker Options: - As a parent/caretaker you have one of three options during the night of the event. 1-Bring the honored guests for an unforgettable prom experience. Parents/caretakers are encouraged to accompany their loved ones through the registration process along with cheer on their honored guests as they walk the red carpet. 2-Stay on campus throughout the event and enjoy the provided Respite Room. We ask all participants of the Respite Room to RSVP below. 3-Participate in the event’s activities with your loved one as a Host. Hosts are a Night To Shine volunteer position and ALL VOLUNTEERS must register Night To Shine volunteer page,be background checked and provide a media release. (after completing the guest registration visit troycc.org/nighttoshine)
RESPITE ROOM REGISTRATION - The Respite Room is a private area where parents/caretakers of guests can spend the evening enjoying food, entertainment and rest while remaining on site during the event.
Parent/Caretaker will be: Select one Dropping Off Enjoying Respite Room Volunteering as a Host Guest will drive themselves
CARE PROVIDER AGENCY INFORMATION - If Applicable - If applicable, please include information about the care provider agency. If a provider agency/care provider will be bringing the guest to the event, the provider MUST stay paired with the guest(s) they accompany throughout the event as a Host. Please inform care provider that registration is mandatory, and that they must accompany this guest throughout the event. The provider agency is responsible for maintaining state-mandated safe ratios to ensure proper care of the guest(s) they are servicing. Register on the Night To Shine volunteer page Additional Notes/Concerns
Volunteer Host request: - If there is a certain individual that will be a volunteer Host for the event and you would like to request your loved one be partnered with him/her, please list the Volunteer Host's name below.
NTS Media Release 2026 - Select ‘yes’ to grant your consent for media release (photos, videos, and social media). If you decline permission for your photos and videos to be taken, select ‘no’. Please read the terms below: By selecting yes below, and for the good and valuable consideration of participating in an event hosted by Troy Christian 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 Troy Christian Church (“TCC”), an Ohio 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 TCC, 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 TCC, and to any benefits inuring to TTF and TCC as a result of its use of any of the foregoing recordings. Among other things, TTF and TCC 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 TCC, for the advancement of TTF and TCC’s exempt charitable purposes. All permissions granted herein extend to any successor or assign of TTF and TCC and bind me and my heirs, successors, and assigns.
NTS Media Release 2026 (cont) - I hereby release and discharge and agree to hold harmless TTF and TCC, their respective 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 with the laws of the State of Ohio, 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.
* NTS Release Select one Yes No
Night to Shine Code of Conduct - Every guest must adhere to the following code of conduct: Guests will exercise proper physical conduct: no inappropriate dancing, touching, or removal of clothing will be tolerated. Guests will need to wear the name tag they were issued matching their identity for the duration of the event for safety of all in attendance. Guests will exercise proper verbal conduct: no cursing or other inappropriate language will be tolerated. Guests will exercise respect toward others and their belongings: no rifling through another's belongings or defacing others' property will be tolerated. There will be no tolerance of any alcohol, smoking, or drug use on premises (with the exception of any necessary prescription medications). If any guest violates this code of conduct, he/she may be asked to leave the Night to Shine event by removal to an unused space. In extreme cases, the guest may be asked to leave the premises. In the case this becomes necessary, the guest's emergency contact person will be notified and steps will be taken to ensure the violating guest's safety while simultaneously protecting the safety of the other guests and the volunteers. By selecting yes below, you agree to adhere to the policies set forth herein. Guests who do not select yes to indicate their agreement to the code of conduct are not permitted to attend the Night to Shine event.
* Night to Shine Code of Conduct Acknowledgment Select one Yes No (This indicates you will not be attending Night to Shine).