Deadline: November 1, 2019

By completing this registration, I agree to voluntarily participate in the GetFit! Exercise and Walking program for the purpose of personal fitness and wellness.  I understand that according to the Centers for Disease Control and Prevention, participating in activity that requires moderate effort is safe for most people. If I have a chronic health condition such as heart disease, arthritis, diabetes, or other symptoms, I will need to talk with my doctor about the types and amounts of physical activity that are right for me.  I agree to accept full responsibility for any injuries I may sustain while participating in this program.  I agree to abide by all rules established for the program.

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* 1. What is your contact information?

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* 2. What county do you live and/or work in?

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* 3. What is the best way to contact you?

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* 4. Which kickoff session do you plan to attend?

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* 5. Which kickoff session do you plan to attend?

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* 6. How physically healthy are you?

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* 7. How important is exercise to you?

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* 8. In a typical week, how many days do you exercise?

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* 9. How many minutes a day are you physically active?

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* 10. Do you feel you get too much, too little, or about the right amount of exercise?

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* 11. Does your fitness routine include activities other than walking?

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* 12. If you answered yes in question 9, what do you most often do for exercise? (check all that apply)

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* 13. Where do you normally exercise?

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* 14. Have you participated in the following? (check all that apply)

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* 15. What is your goal for participating in the GetFit! program?

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* 16. Do you give permission for photos of you to be used without pay for brochures, slide presentations, news article, social media sites, etc. to help provide community awareness of this program?

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