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Registering as an attendee or as a volunteer for this event?(Required)

Are you 18 years of age or older?(Required)

Name:(Required)

Special Needs Attendee Information Only

First Last

Date of Birth:(Required)

Gender:(Required)

Address:(Required)

Street Address Address Line 2 City State ZIP Code

Email Address:(Required)

Enter Email Confirm Email

Contact Number:(Required)

Fun Fact About You:(Required)

Is a "Buddy" be desired?

Each attendee is allowed ONE additional guest during this event. A buddy is a volunteer for those without a guest, that serves as a one-on-one with individuals who may need extra assistance throughout the night.

Emergency Contact During Event:(Required)

This information will be listed on guest's name tag.

Name:

Contact Number:

Health Concerns:

Do you have any health concerns we should be aware of during this event?

Wheelchair/Accessibility Device Dependent?(Required)

Special Communication Needs?(Required)

Please explain your communication needs:(Required)

Please list any sensory issues/concerns:

(strobe lights, camera flashes, loud noises, etc.)

Please list any known allergies:

(foods, animals, latex, makeup, plants or pollen, etc.)

Any medication & toileting assistance needs?

Special Food Needs?(Required)

(food cut-up or pureed, gluten-free, dairy-free, nut-free, etc.)

Please explain food needs:(Required)

How will attendee be arriving at this event?(Required)

Any additional notes/concerns we should be aware of?

Parent/Guest Information

*PARENTS/GUEST/CARETAKERS: Please be aware that for security purposes, "Pickup Cards" will be issued upon drop-off. These cards will be required during the pick-up process. PLEASE DO NOT LEAVE WITHOUT ENSURING YOU HAVE YOUR PICKUP CARD.

Parent/Guest Name(s):(Required)

* Please note: Guests of the attendee must be listed here. Due to venue spacing concerns, attendees are limited to a single guest for this event.

Name:

Contact Number:

Care Provider Agency Information - If Applicable

Care Provider Agency:

(If attending as part of a group, please include the agency or company name)

Agency Contact Number:

Agency Chaperone (If Applicable):

(Note: Chaperone is not required to stay with guest(s) unless required by Care Provider Agency. If the Chaperone remains with the attendee, a Background Check will be required.)

Agency Chaperone Mobile Contact Number:

Any additional notes/concerns?

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Volunteer Block

Parent Name (if under 18):(Required)

First Last

Parent Contact Number:(Required)

T-Shirt Size:(Required)

I understand that ALL volunteers over the age of 18 will require a background check.(Required)

If you don't already have a current background check on file with Cascade Hills Church, a team member will be in contact to facilitate the submission process.

Yes

Emergency Contact During Event:(Required)

Name:

Contact Number:

Special Skills/Training

(Please select all that apply)

Fluent in American Sign Language (ASL)

Special Education Teacher

Healthcare Professional

Current Volunteer in Pure Joy

Special Needs Ministry

Other

Please list the associated healthcare field:

If Other, please explain:(Required)

Have you volunteered at Night to Shine before?(Required)

Volunteer Role Requested:(Required)

(Please select your top three choices. We will consider your request but cannot guarantee a specific role)

* *Virtual Celebration volunteers will assist in providing an unforgettable experience to guests who may need or prefer to participate from home or are facing other barriers to attending in-person. Volunteers will work with church staff to prepare and deliver a crown or tiara to each guest along with decorations, prom favors and more. Volunteers may be asked to drive to and from guest homes, the hospital or group homes and will be required to complete a background check, sign a release and provide proof of a valid driver’s license and car insurance.

Any additional notes/concerns?

Night to Shine Media Rights Release:(Required)

By consenting below, and for the good and valuable consideration of participating in an event hosted by Cascade Hills 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 Cascade Hills Church (“CHURCH”), a Georgia 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.

I consent to the Night to Shine Media Rights Release.

Medication Policy(Required)

Please note that the church, its 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.

I acknowledge the medication policy.

Service Information

Night to Shine Attendee Registration Form

2/13/2026 | 6PM - 10PM

Parent/Guest Information

Care Provider Agency Information - If Applicable

Volunteer Block