Night to Shine Guest Registration - McAlester Campus

Full Name:

Name (as you would like it to appear on name tag):

DOB:

Age:

Gender:

Male Female

Address:

Email:

This address will receive a confirmation email

Fun fact about you (will be read on the red carpet):

Emergency Contact during event (will be listed on guest's name tag):

Emergency Contact phone number:

Will guest be dropped off and picked up by parent/caretaker?

Yes No

Will guest be attending as a part of a group that will provide transportation?

Yes No

If Yes, list Group Home name:

We would love to make your Night to Shine experience the best it can possibly be. If you are comfortable sharing, please answer any of the following optional items that apply in order to help us offer the best support we can. If it doesn't apply, put none.

Does the guest need help acquiring attire for the event? Yes No

Wheelchair: Yes, able to transfer Yes, not able to transfer No

Mobility Needs:

Health Concerns:

Communication Needs:

Sensory Issues/Concerns (ex: strobe lights, camera flashes, loud noises, etc.) (Please be specific):

Allergies (Please list all that apply: FOODS, animals, latex, makeup, plants, etc.) (Please be specific):

Food Needs (food cut-up, gluten free, dairy free, nut free, sugar free, etc.):

Additional Notes/Concerns You Would Like Us to Be Aware Of:

Caretaker Information

Caretaker Name(s):

Caretaker Phone:

Caretaker will be:

Dropping off Guest Enjoying Respite Room

The Respite Room is a private area where caretakers of guests can spend the evening enjoying food, entertainment, and rest while remaining onsite during the event. Please list the names of the caretakers who plan to enjoy the Respite Room:

Care Provider Agency Information – If Applicable

Care Provider Agency (If attending as a part of a group, please include agency or company name):

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

Additional Notes or Concerns:

Night to Shine Participant (Guests & Volunteers) Media Rights Release.

For the good and valuable consideration of participating in an event hosted by Community Culture Church McAlester, 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 Community Culture Church McAlester (“CCC McAlester”), an Oklahoma 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 CCC McAlester 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 CCC McAlester, and to any benefits inuring to TTF and CCC McAlester as a result of its use of any of the foregoing recordings. Among other things, TTF and CCC McAlester 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 CCC McAlester, for the advancement of TTF and CCC McAlester’s exempt charitable purposes. All permissions granted herein extend to any successor or assign of TTF and CCC McAlester and bind me and my heirs, successors, and assigns. I, hereby release and discharge and agree to hold harmless TTF and CCC McAlester, 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.

Do you give CCC-McAlester permission to take and share photos and/or videos of the Honored Guest taken during the event?

Yes No

Description

Friday, February 13th, 2026

Night to Shine 2026 is a world wide prom event for people with special needs sponsored by the Tim Tebow Foundation and hosted by Community Culture Church and the community of McAlester. It is held annually on the Friday before Valentine’s Day, and this event is catered to guests who are 14 years and older.

Honored guests of Night to Shine receive the royal treatment complete with limo rides, cheering paparazzi fans, and a stroll down the memorable RED CARPET. Guests are treated to hair & makeup services, party favors, and an amazing meal. This royal evening of dancing with friends is made complete as our amazing guests are each crowned as King and Queen of the prom!

This complimentary event celebrates people with special needs which fosters a sense of JOY and BELONGING within the community.

PARENTS / CAREGIVERS, We see you! Enjoy the remarkable respite area which live-streams this memorable event so you can relax and be pampered as well. This night for you comes complete with a delicious meal, games, and prizes!

Night to Shine Guest Registration - McAlester Campus

Description

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