“P.A.N.I.C Now - Not Later!”
Register for the 11th Year Anniversary of Barbour Community Health Association's P.A.N.I.C. program: What Does it Mean to Eat More Greens and Be Lean In 2019. Occuring on Mondays: March 4 to April 8, 2019

All participants must be registered. Participants must be at least middle school age (children must be accompanied by an adult) and participate in planned activities.

Name *
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Age *
Address *
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Phone *
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Email *
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Would you prefer to receive P.A.N.I.C. info by email in the future?
Do you have any medical issues that we need to be made aware of? *
If yes: please list:
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“I am aware this is an “at will” event of my choosing. I will not hold Barbour Community Health Association and Belington Wellness Center, or Belington Middle School, for any health issues or accidents that might be related to this event.” I understand that photos taken of me, may be used for advertising said event. *
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