Participant Results

Participant of the Month

You don’t have to be better than everybody else. You just have to be better than you have ever been.

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Contest Period: Begins this summer

I.S. 166 George Gershwin Middle School 800
Van Siclen Avenue Brooklyn, New York 11207

Wednesdays and Fridays 5:00 p.m. – 6:30 p.m.

Registration Period Ends Friday, March 1, 2013

Child's Name*
First Last
Child's Age*
Please enter a number from 12 to 19.
Parent's Name*
First Last
Parent's Age
Primary Phone*
Additional Phone (cell or other)
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
How often does your child work out?*
- Rarely or never
- Once a week
- Two to four times a week
- Five or more times a week
How often do you work out?*
- Rarely or never
- Once a week
- Two to four times a week
- Five or more times a week
How long have you been in the Live Light Live Right Program?*
Have you had previous attempts at weight loss?*
- Yes
- No
What are your fitness goals for the challenge?
Emergency Contact
Emergency Contact Name*
First Last
Emergency Contact Primary Phone*
Emergency Contact Secondary Phone
Agreement
By registering for this challenge, the parent of the Live Light Live Right participant agrees that you are over the age of 18 and have no pre-existing or existing conditions that would prevent you from participating in mild to moderate exercise activities. You also acknowledge that you have read and agreed to the official rules and regulations for the Six Weeks to Fitness Challenge.
By clicking "accept", you agree to the above stated conditions.*
- Accept

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