Guest Registration

Unique ID

Guest Registrations Available

45 Seats Available

Price:

About You

Name(Required)

This name will be on your name tag.

First Last

What is a fun fact about you?(Required)

Date of Birth(Required)

Must be 14 years or older to attend.

Please indicated your gender:(Required)

Female

Male

Meal Choice: Which of the following would you prefer for dinner?(Required)

Chicken Tenders

Meatballs

Ham & Cheese Sandwich

I will bring my own meal.

Contact Information

Email(Required)

Enter Email Confirm Email

Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Emergency Contact Information

Emergency contact information will be listed on the Guest's name tag.

Emergency Contact Name(Required)

First Last

Emergency Contact Phone(Required)

Transportation and Caretaker Information

Guest's Drop-Off Person - Contact Information(Required)

Please enter the name, phone number, and relation to the Guest.

First Name

Last Name

Phone

Relationship to Guest

Who will transport you from the event (pick-up)?(Required)

Same person who dropped-off.

Different person who dropped-off.

Guest's Pick-Up Person - Contact Information(Required)

Please enter the name, phone number, and relation to the Guest.

First Name

Last Name

Phone

Relationship to Guest

Parent/Caretaker or Agency Chaperone Attendance

If you are not attending with your guest, a buddy will be assigned to them.

Guest drop-off or pick-up only .

Attending as Buddy with Guest.
A Volunteer Registration is required in addition to this Guest Registration.

Enjoying the Respite Room.
Respite Room is a private area where Guest Caretakers can spend the evening enjoying food, entertainment, and rest while remaining onsite during the event

Volunteer - Contact Information(Required)

Please enter the name, phone number, and email of the Volunteer attending as your Buddy.

First Name

Last Name

Phone

Email

Respite Room Use - Caretaker - Contact Information(Required)

Please enter the name, phone number, and email of each caretaker who will attend the event and make use of the Respite Room. Max 2 people.

First Name

Last Name

Phone

Email

Releases

The following Media & Liability Releases are required for all guests.

Media Rights Release(Required)

By agreeing below and submitting this form, and for the good and valuable consideration of participating in an event hosted by GRAND POINT 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 GRAND POINT CHURCH (“GPC”), 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 GPC, 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 GPC, and to any benefits inuring to TTF and GPC as a result of its use of any of the foregoing recordings. Among other things, TTF and GPC 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 GPC's exempt charitable purposes. All permissions granted herein extend to any successor or assign of TTF and GPC and bind me and my heirs, successors, and assigns.
I, hereby release and discharge and agree to hold harmless TTF and GPC, 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.

Yes, I agree.

No, please do not share my photo.

Accident Waiver And Release Of Liability(Required)

BY AGREEING BELOW AND SUBMITTING THIS FORM, I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES associated with the
“NIGHT TO SHINE” EVENT on February 9, 2024 hosted by Grand Point Church, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.

I acknowledge that this Accident Waiver and Release of Liability will be used by the event holders, sponsors, and organizers of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity. In consideration of my application and permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:

(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, 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 Tim Tebow Foundation and/or their directors, oﬃcers, employees, volunteers, representatives, and agents, and Grand Point Church the activity holders, sponsors, and volunteers;
(B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise.

I acknowledge that Grand Point Church and the Tim Tebow Foundation and their directors, oﬃcers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a speciﬁc activity on their behalf.

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity. The Accident Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

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.

I agree to the Accident Waiver And Release Of Liability

Event Details

Please Note

There are multiple Night to Shine events happening across Franklin County. Please only register for one event. This registration is for Grand Point Church in Chambersburg, PA.

45 Seats Available

About You

Contact Information

Emergency Contact Information

Transportation and Caretaker Information

Support Questions

Releases