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2021 Stream For Starlight Registration Form

Thank you for your interest in streaming for Starlight!

Please fill out the following information to register your stream.
Contact Information











If outside the US, please choose Other




Participation Details














Your Website and Social Media
In order to promote or feature your event(s)

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.