New Year, New You
Fun Run and Kick-off Event
2nd Annual Healthy Eating Active Living “New Year, New You” Kick-Off Event

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* 1. First Name

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* 2. Last Name

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* 3. Gender

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* 4. Email Address (Optional but strongly encouraged to receive information on future HEAL events.)

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* 5. Address

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* 6. Phone 

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* 7. I will participate in (select all that apply)

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* 8. Will you be participating with a wheelchair, stroller, or bicycle?
**Please note, that for optimal safety and experience, those with wheelchairs, strollers, and bicycles will begin from the back of the start line.

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* 9. Are you interested in purchasing a 2020 HEAL Fun Run T-shirt for $10?
Cash Only

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* 10. Please indicate your t-shirt size

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* 11. Would you be interested in providing feedback via an email survey following the event?

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* 12. I have received, viewed, and agree to the following attachments.
Documents can be found at www.gchd.org/HEAL

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