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Registration for Walking Program
September 9-October 30
Please complete the registration below to participate in the walking program.
1.
Name (First, Last)
2.
Contact Email
3.
I am a
faculty member
staff member
student
Other (please specify)
4.
Do you regularly participate in physical activity?
Yes-more than 30 minutes total per week
No-I do not participate regularly in physical activity (<30 min total per week)
5.
Do you plan on participating in the 5-K (3 mi) at the end of the 8 week program?
Yes
No
Maybe-not sure at this time
Other (please specify)