You are invited to join us as our guest for Night to Shine, a prom designed especially for teens and adults with special needs being held on the evening of Friday, February 8, 2019. Use the form below to register for an evening of dancing, refreshments, a limo ride and the crowning of the prom kings and queens. A buddy will be provided for each guest to escort them throughout the event, ensuring they have the most enjoyable evening. Each guest must register individually. After completing this form, your confirmation will provide a link to submit another guest registration form if needed. Every guest MUST be 14 years of age or older.
AUTHORIZATION, CONSENT AND RELEASE:
Night to Shine Parent/Caretaker Media & Liability Rights Release:
By signing below, and for the good and valuable consideration of participating in an event hosted by REACH 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 REACH CHURCH (“CHURCH”), 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 REACH 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 REACH CHURCH, and to any benefits inuring to TTF and REACH CHURCH as a result of its use of any of the foregoing recordings. Among other things, TTF and REACH 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 REACH CHURCH, for the advancement of TTF and REACH CHURCH’s exempt charitable purposes. All permissions granted herein extend to any successor or assign of TTF and REACH CHURCH and bind me and my heirs, successors, and assigns. I, hereby release and discharge and agree to hold harmless TTF and REACH 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. AGREED TO AND ACCEPTED
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I consent, authorize and agree to the following (required for guest participation): I am the parent, guardian or responsible agency contact with legal authority for the person being registered on this electronic form (herein called GUEST). This guest has my permission to participate in the Night to Shine event sponsored by Reach Church. I understand that as a guest attending Night to Shine, while every effort is made to ensure safety at all times, there is a degree of risk and danger in any public event. If this guest is injured or needs medical attention while participating in Night to Shine, and I cannot be reached, I give Reach Church, its employees and volunteers permission to seek medical diagnosis and treatment which in their best judgment is necessary or appropriate under the circumstances. In an emergency, I further consent to the examination or treatment of this guest by a physician licensed to practice medicine in the State of Delaware, for medical care and services deemed necessary by the hospital, doctor, Reach Church and its agents. I give permission to the doctor or health care professional to provide any and all medical care they deem to be necessary in their professional opinion. I agree to pay for any and all medical expenses incurred as a result of the use of this consent. I agree to fully release and hold harmless Reach Church, its pastors, employees, agents, contractors and other workers, whether volunteer or paid, from any and all injuries, claims, liabilities, or causes of action which may arise from the transportation or participation of this guest in Night to Shine event. I consent to this guest's participation in this free event. On behalf of this guest, I assume all risks in connection with this activity for any harm, injury or damages that may befall my child as a result of his/her participation in Night to Shine, whether foreseen or unforeseen. I give permission for this guest to participate in this activity. In consideration of this guest being allowed to participate in these activities and to use Reach Church's equipment, property, and rental space, I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Reach Church from any and all claims, demands, or causes of action, which are in any way connected with this guest's participation in these activities. I understand that it is my obligation to inform the leadership of Reach Church and Night to Shine event of any and all health considerations or medical conditions that would restrict this guest's participation in this event. I further state that I have fully disclosed all of these considerations and conditions on this electronic form. By electronically signing this statement, I acknowledge that if anyone is hurt or property is damaged during this guest's participation in these activities, I may be found by a court of law to have waived my right to maintain a lawsuit against Reach Church, on the basis of any claim from which I have released them and their staff, volunteers, vendors and agents herein. I agree that any claim or dispute arising from, or related to this agreement, other than a claim for injunctive relief as otherwise provided in the Agreement, shall be settled by mediation or arbitration in New Castle County, Delaware, in accordance with the then governing RULES OF PROCEDURE FOR CHRISTIAN CONCILIATION of the Institute for Christian Conciliation. In the event that the Institute for Christian Conciliation ceases to exist during the course of this agreement, arbitration under this section shall be conducted according to the rules of the American Arbitration Association. Judgment upon an arbitration award may be entered in any other court otherwise having jurisdiction. I agree that each party, myself and Reach Church, shall bear our own costs related to any other medical or arbitration proceeding. AGREED TO AND ACCEPTED
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EVENT LOCATION DETAILS: Friday, February 8, 2019 5:30pm - 9:00pm Reach Church - Summit Bridge Road Campus - 2880 Summit Bridge Road, Bear, DE 19701