Long Island 2 Day Walk to Fight Breast Cancer

ZUMBA Marathon Registration

The Fitness Studio of Eastport, NY is pleased to present a ZUMBA Fitness Marathon to benefit the Long Island 2 Day Walk To Fight Breast Cancer.

Experience a one-of-a-kind calorie-burning and body energizing workout. Features interval training sessions where fast and slow rhythms and resistance training are combined to tone and sculpt your body while burning fat.

March 13, 2010
9AM Registration & Sign In
St. Joseph's College
John A. Danzi Athletic Center
Patchogue, NY 11772

Cost: $20 Per/Person (Pre-Registered) or $25 Per/Person on the day of the event.

Please complete the registration form below to participate in this event.

After submitting the form below and on approval of your credit card you will be placed on our Pre-Registration List. On the day of the event please come to the "Pre-Registration" table to sign in.

This event has a maximum of 100 participants.

Refreshments will be on sale during the sessions. The St. Joseph's College Dance Club will benefit from the proceeds of the refreshment sales. The club is committed to supporting local charities. We thank them for their commitment and dedication.

Personal Information (Please complete all fields):

Name:

Address 1:

Address 2:

City: State: Zip:

Daytime Phone: Evening Phone:

Email Address:

Order Information:

Pre-registration costs $20 per/person. If paying by credit card please enter your information below - your card will be charged $20 for the pre-registration. If paying by check please forward a check payable to LI2DAYBCW for $20 to:

LI2DAYBCW
P.O. Box 506
Nesconset, NY 11767
Please enter "ZUMBA" in the memo section of your check to ensure proper credit.

Payment Method: Credit Card Check

Name on Card: Card Type:

Card Number:

Expiration Date: / Billing Zip Code::

THANK YOU FOR SUPPORTING LI2DAY!

Please Note: You will receive a confirmation email after submitting the form above. On the day of the event please check-in at the "Pre-Registration" table. Thank you!

Privacy Statement:
All information received by LI2DAY is for our purposes only. None of your personal information is ever shared with third parties or anyone outside the LI2DAY organization. All information is transmitted to our database using encryted SSL technology for your safety and security.