2021 Stream For Starlight Registration Form
Thank you for being a part of Stream For Starlight this March!
Please fill out the following information to confirm your participation.
Mailing Address (for prizes)
Address line 1
Address line 2
Were you contacted by a Starlight staff member?
Which Starlight staff member?
What is their name?
How will you be fundraising during your stream/virtual event?
I'd like my own S4S fundraising page
I'll be using a native Fundraising Tool (Facebook or Instagram donate button)
I will be collecting donations myself and sending to Starlight
Not sure/Need assistance
Name of your event:
Category of your stream
Art & Design
DIY & How To
Fashion & Style
Fitness & Sports
Food & Drink
Kids & Family
If other, please explain:
Dates of your event(s)
March 10 - 31: Multiple days
March 10- 31: One day
What are the specific date(s) and times of your event(s)? Please include start and end times (even if an estimation)
What time zone will your event take place in?
Alaska Standard Time (AKST)
Hawaii-Aleutian Standard Time (HST)
Pacific Standard Time (PT)
Mountain Standard Time (MT)
Central Standard Time (CT)
Eastern Standard Time (ET)
Atlantic Standard Time (AST)
If other or unsure, what state/country are you located in?
Where to view your stream:
What will you be streaming?
Are you interested in Starlight's other 2021 streaming events?
Childhood Cancer Awareness Month (9/1 - 9/30)
Stream Halloween (10/31)
12 Days of Streaming (12/1 - 12/12)
Your Website and Social Media
In order to promote or feature your event(s)
Please provide a photo we can use to promote your event.
Starlight can feature me in social media posts
Story and Photo Consent
I grant Starlight permission regarding the following: I grant Starlight and any of Starlight’s agents, corporate partners, assignees, or licensees (“Released Parties”) the irrevocable, unconditional, and unrestricted right (but not the obligation) to use any photographs, videos, my name, image, personal characteristics, essays, personal story, biographical material, artwork, voice and/or likeness (“Materials”) in any promotions, publicity, and advertising utilizing the Materials respecting the Released Parties. I acknowledge that I will not receive any compensation for any use of the Materials. I waive and release all Released Parties from any and all claims or demands. I may now, or in the future, have, arising out of, or in connection with, this release agreement or the Materials including, without limitation, any claims respecting invasion of privacy, copyright infringement, right of publicity, defamation and any other personal and/or property rights. By providing my email address to Starlight, I am opting in to receive emails from Starlight regarding this event and other Starlight news.
I have read and understood this consent and release, and understand that Starlight may share my photo and story in promotional materials.