HomeMy WebLinkAboutU B HEALTHY SUMMITPORT ARTHUR HEALTH
DEPARTMENT
449 AUSTIN AVENU ~:
Registration Is FREE
NAi~t E:
AD[ !~ ESS:
AGE:
I do/do not (c~r~ie one) give permission for my child,
on "Girl's Health Issues", "Boy's Health Issues"
PARENT'S NAME:
PARENT'S SIGNATURE:
and "STD/HIV/HPV".
PARENT'S PHONE #:
DATE:
to attend the sessions
MAIL TO: YOSHI ALEXANDER, HEALTH DIRECTOR, 449 AUSTIN AVE., PORT ARTHUR, TX 77640
Registration Deadline is 07-24-09