Booth Registry

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To register for a booth at the Healthy Fair, please complete the form below.

A confirmation email will be sent to you in 24 - 48 hours.

Booth Registry Form

Booth Type:*

Practice/Business/Dept Name:*

Specialty:*

Contact Name:*

Phone:*

E-mail:*

T-shirt Size:

T-shirt Size (2nd):

Screening:*

YesNo

If yes - what kind:

Door Prize:*

YesNo

Electrical Outlet:*

YesNo

Interested in receiving sponsorship information:*

YesNo

Comments:

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