Healthy Walk Registration Form

2009 HBCU National Walk for Health
Walk with the 105 Voices from the Kennedy Center
to the Lincoln Steps

Legacies Reflection at the Reflecting Pool
Walk National Partner - Aetna Foundation

Thank you for participating in the Inaugural Healthy Walk for the 105 Voices of History HBCU National Concert Choir in recognition of Historical Black Colleges and Universities Celebration week. Join us in linking the arts to health which has many rewards to support healthy lifestyles. Please complete the registration form below with your contact information.

NAME: (REQUIRED)

ADDRESS: (REQUIRED)

City: (REQUIRED)

State: (REQUIRED)

Zip Code: (REQUIRED)

HBCU you attended or currently attend:

Friend of an HBCU:

TELEPHONE NO.: (REQUIRED)

ALTERNATE CONTACT NUMBER:

Email:

Affliliation:

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