Health is Wealth Fair 2021 Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for your interest in participating in the inaugural KIPP Miami Health is Wealth Fair 2021 at the Belafonte Tacolcy Center! Please complete the form below to secure your registration. Spots are limited!

Child(ren)'s full name *

Child(ren)'s age *

Parent/guardian full name *

Parent/guardian email *

Parent/guardian phone number *

Home address *

Referring agency or organization *

Select which portion of the Health is Wealth Fair your CHILD(REN) will be participating in. Check all that apply: *

8:00am 2 mile historic run (TRiBe Run Club)

Dance Clinic

Agility Clinic

Run Clinic

Required

Select which portion of the Health is Wealth Fair the parent/guardian (YOU) will be participating in. Check all that apply: *

8:00am 2 mile historic run (TRiBe Run Club)

11:15am Nutrition education lesson (EatWell Exchange)

12:00pm Mental health discussion panel with licensed professionals (KIPP Miami)

Required

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of KIPP New Jersey. Report Abuse

Forms