Night to Shine Guest Registration

NTS Tim Tebow final.jpg

We are so excited to having you joining us for Night to Shine sponsored by the Tim Tebow Foundation, hosted by Calvary Chapel Eastside!  Before you fill out the registration form below, please take a moment to fill out the Parent/Caretaker Media & Liability Rights Release for this event. This form MUST be either emailed or mailed to Calvary Chapel Eastside BEFORE the event.  If emailing, please send to our Church Office at info@cceastside.com.


Please read through and fill out this form carefully to help us make sure all the information we have on file is correct.

Name *
Name
Address *
Address
Emergency Contact *
Emergency Contact
Please list someone who can be contacted during the event in case of emergency.
Emergency Contact Phone *
Emergency Contact Phone
(strobe lights, camera flashes, loud noises, etc.) Please write N/A if not applicable.
Please list all that apply: food, animals, latex, makeup, plants, pollen, etc. Please write N/A if not applicable.
(food cut-up or pureed, gluten free, dairy free, etc)
Please note that the 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 Name *
Parent/Caretaker Name
Parent/Caretaker Phone *
Parent/Caretaker Phone
Additional Parent/Caretaker Name
Additional Parent/Caretaker Name
Parent/Caretaker Phone
Parent/Caretaker Phone
If you are planning on remaining on site during the course of the event, please fill out the box below. The Respite Room is a private area where parents/caretakers of guests can spend the evening enjoying food, entertainment and rest while remaining onsite during the event.
(if applicable)
Care Provider Agency Phone
Care Provider Agency Phone
(if applicable)
Agency Chaperone
Agency Chaperone
(if applicable) Note: Chaperone is not required to stay with guest(s) unless required by Care Provider Agency