BROWNSVILLE, TEXAS

5th Annual Vive Tu Vida! Get Up! Get Moving!

Saturday, October 22, 2016 from 9:00 AM 1:00 PM
Dean Porter Park
501 E. Ringgold Street, Brownsville, Texas 78521
Expected Number of Participants: 5,000

BOOTH REGISTRATION FORM

CONTACT INFORMATION:
Name:________________________________________________________________________________
Title:_________________________________________________________________________________
Name of Organization/Business:___________________________________________________________
Address:______________________________________________________________________________
City:___________________________________State:_______________________Zip:________________
Tel: ___________________________________________ Fax: _________________________________
Email:________________________________________________________________________________
Sponsorship Level:

PLATINUM

Electricity Needed:

Yes

For Profit Business/Organization:

GOLD

SILVER

NO
$150

Nonprofit (fee will be waived)

Topic/Activity/Demonstration_________________________________________________________________

SPONSORS: For any additional information please feel free to contact

Maria Maldonado, O&E Representative at mariam.bchc@tachc.org and or
Cristela Gomez, PCMH Coordinator at cgomez.bchc@tachc.org,
Office: (956)548-7514 or Cell: (956) 453-7640, Fax: (956) 621-3689
Sponsors please submit your company logos no later than September 30, 2016.

Making a Difference in Health Care:

Yesterday, Today, and Tomorrow