The Beulah Boys -  Soul Line Dancers
REGISTRATION FORM
THE BEULAH BOYS' 1ST ANNUAL PROSTATE CANCER AWARENESS 5k RUN-WALK
NAME
ADDRESS
CITY, STATE & ZIP
AGE (OPTIONAL, WILL BE USED FOR CATAGORIES)
CONTACT PHONE NUMBER
EMAIL
WAIVER - I am voluntarily participating in the aforementioned activity and I am participating in the activity entirely at my own risk. I am aware of the risks associated with participating in this activity, which may include, but are not limited to, physical injury or illness. I understand that these injuries or outcomes may arise from my own negligence, or the condition of the activity location, nonetheless, I assume all related risks, both known and unknown to me, of my participation in this activity.
I ACCEPT

18 & under must have parents' permission - PARENT ACCEPTANCE

EMERGENCY CONTACT NAME & NUMBER
Thank You
for your continued support
 and your help to bring awareness to
PROSTATE CANCER 
 


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My Movie
THE BEULAH BOY'S PERFORM 285 - ATL. FOR "NDRC SENIORS ON THE MOVE" IN CHARLOTTE, NC. MUSIC: DO YOU FEEL ME BY KIRK WHALUM
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We're booked for several
private events. We'll have as many of them as possible
posted on Facebook and
U tube for your viewing pleasure.

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    PLEASE COME OUT AND ENJOY OUR PERFORMANCES
***********
THANKING YOU IN ADVANCE FOR YOUR SUPPORT!
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         We'll update the website
with any other
open events to come.
 
Please contact us to
book your next event.
Contact Person-Nick Bowers
 @ 404 310-0067
or EMAIL dcbowers55@msn.com
or crappie30@msn.com
 
 

 
 
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