Healthy Lifestyle Challenge Pre-Registration
Welcome to the "Healthy Lifestyle Challenge, A Year to Transform Your Life"!

This challenge is a 1-year commitment to get you headed to a healthier new you! Join your community as we work together to reach healthy weights, develop healthier eating habits, improve sleep, and more!

With this challenge you will get the support and accountability you want to keep you motivated.

Are you ready to commit and join today? If so, let's go!

Simply complete the pre-registration information below. Once completed, you will begin receiving updates about our upcoming "Summer Kick Off Event" in July!

Important: All participants must be 18 years of age or older.

Please complete the following pre-registration below:

Sign in to Google to save your progress. Learn more
First Name
Last Name
Address
Phone number
Email address
Date of Birth
MM
/
DD
/
YYYY
Are you participating as an Individual or Group?
Clear selection
If you are participating as a group: Please list 3 other group member participants & the name of your group/team. Reminder: all participants must pre-register even if they are participating in the group category.
Why are you interested in joining the Healthy Living Challenge?
Clear selection
How did you hear about the "Healthy Living Challenge- A Year to Transform Your Life?
Clear selection
Are you willing to receive emails/texts regarding updates about the challenge at the email address or number you provided?
Clear selection
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of State of Maryland. Report Abuse
Google Forms