Night to Shine 2026
Registration Information
Night to Shine will be held at the St. John Ascension Sportsplex located at 101 E 81st St S.,Tulsa, OK 74132. Event is February 13th from 7 p.m. - 10 p.m. **Due to our current registration you will have to provide your own buddy for this event if registering less than 30 days before the event.**
Guest Information
First Name
*
Last Name
*
Full Name
*
First Name
Last Name
Gender
*
Male
Female
Is {firstName} 14 years or older?
Please Select
Yes
No
E-mail
*
example@example.com
Birthday
*
-
Month
-
Day
Year
Date
Caregiver Name
*
First Name
Last Name
Caregiver Cell Phone Number (Must be on-site for the night)
*
Street Address
Street Address Line 2
City
State/Province
Postal/Zip Code
Emergency Contact Name:
*
First Name
Last Name
Emergency Contact Phone Number:
*
Please enter a valid phone number.
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Caretaker Information
Agencies bringing guests to this event are required to provide one designated caretaker for each guest in attendance. A 1:1 guest-to-caretaker ratio must be maintained on-site for the duration of the event. We must have a working cell phone number for the caretaker who will be on site.
*
Please Select
I agree
Care Provider Agency
If applicable
Care Provider Agency
Care Provider Cell Phone Number:
Please enter a valid phone number.
Will the caregiver be staying to enjoy the Respite Room?
*
Please Select
Yes
No
Restroom Assistance Necessary?
*
Please Select
Yes
No
***Restroom Assistance - If a guest requires restroom assistance you MUST provide a buddy for the night as we are unable to assist in the restroom***
*
Please Select
I Agree
Any special needs we should be aware of? (dietary restrictions, sensory issues, allergies, etc)?
Additional Notes or Concerns:
By checking the box below, and/or by participating in an event hosted by, sponsored by, or associated with the Tim Tebow Foundation and The Assembly at Broken Arrow, I hereby give my full consent to Tim Tebow Foundation, Inc., (“TTF”) a nonprofit corporation headquartered in Florida and The Assembly at Broken Arrow (“CHURCH”), 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 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 the Participants and their 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 States of Florida and Oklahoma, 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.
*
Please Select
I agree to the media consent and Liability Rights Release
Submit
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