Registration

Please check the following boxes and send it to us via fax, email, or mail.

Send it to: Gaia Holistic Health Cirlce: 20 W 64th St, #24E, New York, NY 10023 Tel: 212-799-9711 Fax: 212-799-1661 Email health@gaiahh.com

1. I'll be one of the leaders and encourage others to join us.
   
   
2. As a leader, I'll volunteer in some way or another.
   
   
3. I have joined the event _____ times in the past.
   
   
4. I'll join you to climb to the top of the mountain.
   
   
5. Send me _____flyers.
   Name:_________________________________________
   Address: ______________________________________
   Telephone: ____________________________________
   FAX: __________________________________________
   E-Mail: ________________________________________