Congressional Black Caucus Foundation, Inc.

Online Registration

We're delighted that you've decided to join us at a Black Health Empowerment Project event. Pre-registrants qualify for great prizes so encourage your family and friends to register today as well.** Please confirm your attendance by completing the form below or calling 1-888-353-BHEP (2437). Come ready to move and learn!

Salutation:
First Name:	*
Last Name:	*
Address:
City:
State:
Zip:
Phone (Work):
Phone (Home):
Email:
A. For which city would you like to register?
Registration City:
B. Which activities are you planning to attend?
Activities:
C. How many children would you like to register for the youth activities?
Number of Children:
Children's Age:
D. How did you hear about the BHEP event?
Choose:
E. Would you like to receive updates about BHEP?
Select:	If yes, please provide your email address above.

* This field is required.

** Must be present at time of drawing to win.