Volunteer Registration Form | Night To Shine at Visalia First – Night To Shine at Visalia First

Buddy Team Volunteer Registration

Information

Name *

First

Last

Date *

Gender: *

Male
Female

Address *

Address Line 1

City

State

Zip Code

Email *

Phone *

If you are under the age of 18, a permission slip signed by your parent is required to volunteer (must be between 16-17). Are you under 18? *

Yes
No

Parent Name (if under 18):

Parent Phone (if under 18): (copy)

Please click HERE and have your parent fill out and sign the volunteer permission slip for volunteers ages 14-17.

Emergency Contact During Event:

Emergency Contact Phone:

Background checks are required for ALL volunteers over the age of 18.

*I have had a background check within the last 12-18 months: *

Yes
No

Special Skills/Training (please check all that apply):

Fluent in American Sign Language (ASL)
Special Education Teacher
Healthcare Professional (is so, please list field below)
Current Volunteer in Visalia First's Special Needs Ministry
Other (please explain below)

Healthcare Professional Field:

Other Special Skills/Training

I Have Volunteered at Night to Shine Before: *

Yes
No

Single Line Text

Volunteer Media and Liability Rights Release
By signing below, and for the good and valuable consideration of participating in an event hosted by VISALIA FIRST, 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 VISALIA FIRST (“VISALIA FIRST”), a California 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 VISALIA FIRST, 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 VISALIA FIRST, and to any benefits inuring to TTF and VISALIA FIRST as a result of its use of any of the foregoing recordings. Among other things, TTF and VISALIA FIRST 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 VISALIA FIRST, for the advancement of TTF and VISALIA First’s exempt charitable purposes. All permissions granted herein extend to any successor or assign of TTF and VISALIA FIRST and bind me and my heirs, successors, and assigns. I, hereby release and discharge and agree to hold harmless TTF and VISALIA FIRST, 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 California, and should any provision of this release be determined invalid, such invalidity does not affect any of the remaining provisions.

I am 18+ and hereby AGREE TO AND ACCEPT the terms of this Volunteer Registration and Media Rights Release: *

I am 18+ and hereby AGREE TO AND ACCEPT the terms of this Volunteer Registration and Media Rights Release

I, the applicant for this permission form, warrant the truthfulness of the information provided in this application. *Electronic Signature (Please type your first and last name)* *

I understand that checking this box constitutes a legal signature confirming that I acknowledge & agree to the above Terms of Acceptance.

Date *

Date

Time

Participant Signature *

Clear Signature