Friday, February 8, 2019 from 6:00 PM to 9:00 PM EST
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Grace Community Church - Marion, North Carolina

5182 US 70 West
Marion, NC 28752

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Wanda Hester
Grace Community Church

A Night To Shine Guest Registration

Grace Community Church is pleased to host A Night to Shine on February 8, 2019 in Marion, North Carolina. This event is an unforgettable prom night experience, centered on God's love, for people with special needs. To register a guest, please use the form below.

* Required information

Personal Information

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  • Wheelchair

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  • Special Communication Needs

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  • Food Needs (Food cut-up or pureed, Gluten free, etc.)

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Night to Shine Parent/Caretaker Media & Liability Rights Release

  • By signing below, and/or by or in consideration for participating in an event hosted by, sponsored by, or associated with the Tim Tebow Foundation and Grace Community Church, Marion, NC. I hereby give my full consent to Tim Tebow Foundation, Inc., (“TTF”) a Georgia nonprofit corporation headquartered in Florida and Grace Community Church - Marion, N.C. (“CHURCH”), a North Carolina organization, 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 is 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 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 the State of North Carolina, 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.

  • *** By typing your name here, you are signing this form electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this form.


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