3rd Annual Black Maternal Health Walk-A-Thon          Registration Form
The Healthy Baby Network will be having our 3rd annual Black Maternal Health Walk-A-Thon. Join us as we walk and talk about the challenges and solutions during Black Maternal Health Week. We will see you on Saturday, April 11th at 9am at the Greece Mall. This walk is for the entire family. There will be activities, resources, and education for all ages. 

Pre-registration is a requirement so please complete the form below for each participant. 
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