Registration Form

YPAM.Registration form

Registration Form

Please select the progam
Basic Information:
Do you agree to have your name to be displayed on the YPAM contribution page?

If you select no, your name and organization will display as Anonyms

Parent's Consent

WAIVER OF NEGLIGENCE & COMPLETE RELEASE OF LIABILITY

I am physically capable of participating in this YPAM event.

If I am under the supervision of a medical care provider, my provider is aware and approves of my participation in this event.

I understand that by participating in this event, I will be using public places, public streets, and facilities where many hazards exist, and I am aware of and understand the risks associated with these hazards.

I am voluntarily participating in this event with the knowledge of any potential hazards, and I agree to accept any and all risks that may result in my injury or death.

I acknowledge that I, and I alone, bare solely responsible for my personal health and safety, and any personal property I bring with me to the event.

I agree to assume all risk and to release and hold harmless Youth and Parents Association of Markham and their affiliated organizations, sponsors, officials, participating clubs, government or public entities, save and except injury caused by their negligence and/or that of their agents and employees or their intentional acts or omissions.

I am aware that this is a RELEASE OF LIABILITY and will act as a contract between myself and all persons and entities mentioned above, and all of their respective officers, directors, agents, and representatives and I agree to all of the conditions set above.

As part of our mental health walk, YPAM is collecting pledges online, with all funds being given to the Markham Stouffville hospital's mental health project. 100% of all pledges will be given directly to Markham Stouffville Hospital. All of YPAM's administration costs for this event will be paid by YPAM. YPAM will make an announcement on our website with regards to the amount of money collected on behalf of the hospital.

YPAM thank you for your pledge towards child and adolescent mental health programs to support Markham Stouffville Hospital. For more information visit www.ypam.ca/mentalhealth or to donate more visit https://mshf.on.ca

Payment

Pledge amount (in CAD $) :

Late Registration Fee :

Total Fee :

Total Fee :