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PERMISSION FOR ENROLLMENT AND RELEASE OF YMCA LIABILITY:  I understand that even when every reasonable precaution is taken, accidents can sometimes happen. Therefore in exchange for the YMCA allowing me, my child or other family members to participate in YMCA activities, I understand, and expressly acknowledge, that when I, my child or other families attend the YMCA’s facilities or programs, or when using any equipment located on or off the YMCA’s premises, we do so at own risk.  I release the Fort Myers YMCA, the Fort Myers Track Club, Royal Palm Square Co. and it’s staff members, it’s Directors, officers, and agents from all liability for injury, loss or damage connected in any way whatsoever to participation in YMCA activities, whether on or off the YMCA’s premises. I understand that this Release includes, but is not limited to, any claims based on negligence, action or inaction of the YMCA, it’s staff, directors, officers, agents, representatives and guests. I have read the form and grant permission for my child to participate in all activities provided by the YMCA.  I authorize the staff of the YMCA, or appropriate medical personnel to administer emergency medical treatment to me, my child or other family members. I also understand that I am solely responsible for all costs incurred as a result of such treatment. I have read and voluntarily signed this Authorization and Release. Further, I hereby give full permission to any and all of the foregoing to use any photographs, video tape, motion pictures, recordings, and any other record of this event for legitimate purposes.

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I acknowledge that registration fees are non-transferable and *non-refundable.



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**THIS DOES NOT GUARANTEE A SHIRT. SHIRTS ARE GIVEN OUT WHEN PACKETS ARE PICKED UP-FIRST COME FIRST SERVE. 

Proceeds of the Midpoint Madness Veteran's 5K benefit the Fort Myers YMCA youth and family scholarship program.

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{{crowdriseTeam.entryName}} Charity Event Fundraising on Crowdrise

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