Accu Weight-Loss "The Bead Diet"

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Revlon Run/Walk

Internal Use Only

Revlon Run/Walk For Women
TEAM ACCUWEIGHT

Saturday, May 3rd, 2014
REGISTRATION
(Complete Form Below)

Accu Weight-Loss "The Bead Diet" will pay the registration fee of $35 for all clients wishing to join Team AccuWeight.  Friends and family wishing to participate may join the team but are responsible for their own registration fees.

Once registered, we will provide you with instructions and guidance for fundraising.  Revlon provides each registrant with their own fundraising website to assist in the process. 

On event day, AccuWeight will host a picnic in Central Park for all participants and their families (indoor picnic if inclement weather).  We will ensure all clients are on a vegetable day so are able to participate.

To register, please complete the below form.  If you are not ready to register, but would like more information, please contact Gerri Cannistra at revlon@accuweight.com or (631) 648-9141.

Please email information to info@accuweight.com
Form temporarily unavailable
Gender (F/M)
Date of Birth (mm/dd/yyyy)
First Name
Last Name
Address Line 1
Address Line 2
Zip Code
City
State
E-mail Address
Daytime Phone() -
T-Shirt Size (S, M, L, XL)
I am a cancer survivor (Y/N)
Receive Revlon Email Newsletter (Y/N)
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 Accu Weight-Loss
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 Accu Weight-Loss Systems, Inc. and AccuQuest Health Programs, Inc.