The GUT Patrol Health Fair Registration

Health Fair Registration - March 19, 2022

Life Enrichment Center, 3805 Tarheel Club Road, Raleigh, NC 27604 * 12 - 3 PM. We look forward to you joining us at The Connection Place's first Health Fair with our project, "The GUT Patrol. Please complete one registration for each person attending. For more information join The GUT Patrol Facebook page.
Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Mobile Number
or Home Number
Please check appropriate category.

AttendeeSpeakerStaffVendorVolunteer
If you would like to become an Ambassador and spread the word to your community about Colorectal Cancer Awareness, indicate below or connect with us after the Health Fair.

I would like to become an Ambassador.
Additional Comments
Note: Video taping and photography will occur on the day of the Health Fair and will be used for promotional and historical purposes. Your registration acknowledges that you have read this statement and are in agreement to being in the presence of videographers and photographers and may be captured on their media. If you have a testimonial after the event, please see one of our volunteers. Thank you.
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Health Fair Registration - March 19, 2022