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Gala Registration Form

To resgister please fill out this form

Health & Fitness 4 Minority Women, Inc. *

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Gala Registration Form

Name/Company's Name:

Address/City/State/Zip:

Contact Number:

Email Address:

Please check the appropriate box:

For Groups Please list the names of your members

Please enter the number of Persons

Please enter the amount registered:

For Checks Please mail your registration to:

Health & Fitness 4 Minority Women, Inc

Attn: Health Education/Prevention Programs

7118 Orral street, Oakland CA 94621


"Striving to Make Women Healthy"

Oakland, California 94621; 510-472-5232

501(3) c - Since 2010 HF4MW Inc.

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