I give my permission to the Hardin County Family YMCA to use photographs, film footage, or tape recordings, which may include mine or my family's image or voice for purposes of promoting or interpreting YMCA programs or activities. Participant specifically assumes all risks of injury arising out of his/her presence on the premises of the Young Men's Christian Association (the "YMCA"), use of its equipment or facility and participation in its activities, whether on its premises or at another location. For myself and my heirs and assigns, hereby waive, release and agree to hold free from all claims for damages the Young Men's Christian Association and its officers, directors, members, employees or agents. I understand the risks and dangers involved in participating in the programs and activities of the YMCA, are physically capable of participating in such programs and agree not to participate in any activity that may injure myself or others.
I swear/affirm that I am not a registered sex offender in any jurisdiction. Any falsification of this registration form or of the signatures will result in termination of membership.
By participating in the YMCA Nationwide Membership Program, I agree to release the National Council of Young Men's Christian Associations of the United States of America, and its independent and autonomous member associations in the United States and Puerto Rico, from claims of negligence for bodily injury or death in connection with the use of YMCA facilities, and from any liability for other claims, including loss of property, to the fullest extent of the law.
I authorize my bank to honor pre-authorized drafts drawn by the YMCA on my account for membership payments and/or contributions. When the bank or credit card carrier honors the draft by charging my account, such drafts constitute my receipt for the payment. If at any time there is to be a cancellation of my membership, I will come into the Hardin County YMCA to fill out the proper paperwork and understand it will take 30 days for membership to be canceled. With a balance owed, terminations will not be accepted until past due balances are paid in full.
I accept all provisions of membership set forth above and, understanding the Mission of the YMCA, hereby apply for membership. I understand that information given for my YMCA membership is the property of the YMCA and is kept as confidential.