top of page

Gala Registration Form

To resgister please fill out this form

Health & Fitness 4 Minority Women, Inc. *

Buy your tickets online by pushing the "Pay now" button

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:

2011 5th Annual Gala Tickets

$75.00Price

For Checks Please mail your registration to:

Health & Fitness 4 Minority Women, Inc

Attn: Health Education/Prevention Programs

7118 Orral street, Oakland CA 94621

bottom of page