registration begins here

Please enter me in the "Walk for Dyslexia-Madison". 

I, on behalf of myself, my heirs, executors, and administrators hereby release the Madison Area Children's Dyslexia Center from any and all claims, damages, and rights of action I may have, present or future that may arise out of, or be incident to my participation in the Walk event. In addition I grant permission for the use my name and/or picture in any photograph, film or videotape of the event for any purpose.