Heath Fair On-Line Entry Form

Registration Form

Thank you for registering for the Heath Fair! You can get started by filling out and submitting this form. After you complete the initial registration, you will be able to submit multiple entries for the category you have selected.

* All of the fields below are required

1 Enter Your Contact / Personal Information

If you are entering for an organization, under First Name enter the name of the organization, under Last Name enter your full name

First Name:

Last Name:

Address:

City:

State:

Zip:

Phone:

You must enter a ten digit phone number that includes the area code in "555-555-5555" format (only numbers and hyphens are allowed)

Email:

Premium Book Age Group for your Department as of January 1 of the current year:

Age of Entrant:

By using this form you agree with the data storage and handling policy of this website.

Heath Fair August 2024

Registration Form

1 Enter Your Contact / Personal Information

2 Choose a Department

3 Start Submitting Entries