Let's Get Healthy Registration

If you and your child are interested in joining the Let's Get Healthy! program please fill out this form and submit it.

* Asterisk indicates required field.

Which class would you like to register for?



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(mm/dd/yyyy Format)
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Gender

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If your child does not see a Henry Ford physician, please have your child's physician complete a medical release form.
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How would you like to be contacted?
 
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Register for the Let's Get Healthy Program