Walk with a Doc - Berkeley, CA
Hi there! Thank you for signing up for the 1st Quarterly Walk with a Doc - Berkeley, CA! This day will be a day in which we can walk together to promote good health and well-being; we are excited that you'll be joining us.

When: Saturday, October 19th, 2013
Where: San Pablo Park, Berkeley, CA
Time: 9AM (registration & blood pressure screenings), 10AM (Dr. Janet's health talk & walk) - 12PM
Contact: Mint at wwad.berkeley@gmail.com for questions, comments, and concerns!
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Name *
E-mail address *
You are pre-registering for the walk on October 19th!
Would you like to sign up for the National WWAD newsletter?
For health tips, exercises, and new WWAD locations!
Would you like to volunteer at WWAD - Berkeley, CA on Oct. 19th? *
Volunteers will need to arrive at 8AM and remain for the duration of the event (end of clean-up at 12PM) unless otherwise noted beforehand.
Are you a physician or health professional interested in speaking to participants about health, and etc.? *
Physicians and health professionals will receive a distinct nametag.
If yes to the above, what is your title and profession?
For example: Dr. David Sabgir, MD, Cardiology
What services will you be able to provide on the day of the event?
For volunteers and health professionals; you may choose more than one!
What health topics are you confident in speaking about to walkers?
Only for doctors, health professionals, and health adviser volunteers; for example: hypertension, obesity, diabetes, nutrition, physical therapy, etc.
Comments? Questions? Concerns?
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