Ft. Berthold Diabetes Virtual Bingo Registration
Event Timing: November 5th - 24th, 2020
Event Address: Streaming LIVE via ZOOM.com
Contact us at (701)627-7931
Virtual Diabetes Bingo
*Diabetes bingo open to ages 8 yrs. and older
*Each participant must register with the segment in which they reside.
*BINGO CARDS WILL BE MAILED 1 WEEK PRIOR TO BINGO EVENT DATE TO MAILING ADDRESS PROVIDED ON REGISTRATION.
* If participant registers less than a week prior to Bingo event date, then participant must pick up Bingo cards from Awatii Wellness Center or other agreed upon location.
First & Last Name *
Date Of Birth *
MM
/
DD
/
YYYY
Phone Number ex: (xxx)xxx-xxxx *
Which Virtual Bingo will you be participating in? (Must reside in segment to participate) *
Email Address
Full Mailing Address- address, city, state, zip code- (This is the address your Bingo cards will be mailed to 1 week prior to the event date) *
Full Physical Home Address- address, city, state, zip code *
Any questions call 627-7931
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