2026 Mental Health Matters Walk Cumberland YMCA - Arena 601 Kelly Road Cumberland, Maryland 21502 Tuesday, May 12, 2026 5:30 pm - 7:30 pm Participant Registration Form Participant Name Address Street Town / City State Zip Code Contact Information Phone Number Email Address Emergency Contact Information Name Phone Number Relationship ParentSpouseGuardianSibling (over 18)FriendOther Please specify relationship By completing this form, I understand and agree to the following: This is a drug/alcohol/tobacco/vaping free event. Animals, including emotional support animals, are not permitted without preapproval from the Cumberland YMCA. The LBHA is not responsible for lost or stolen items. Failure to comply with the above guidelines can result in being asked to leave the event. I hereby confirm I am physically fit and without any medical condition, disability, sickness, or ailment that would hinder my ability to participate in the Mental Health Matters Walk. Participant Signature Parent / Guardian (if under 18) Date By providing your information, you consent to being contacted by phone, email, or text message regarding your request. Photo Release: Allegany County Local Behavioral Health Authority will take photos/videos at this event. By registering, you agree that Allegany County Local Behavioral Health Authority may use these images in publications, social media, or other promotional materials. Submit Registration
