Self-Care Challenge Sign Up Form

Complete the form below if you plan to participate in either of the Self-Care Challenges starting February 1st, 2021.

Email address *

First & Last Name *

I would like to join ... *

the 12-Day Self-Care Challenge (February 1st - 12th, 2021)

the 4-Week Self-Care Challenge (February 1st - 28th, 2021)

My financial commitment ... *whatever you can afford is enough. If you can't afford anything right now, that's fine too.* *

My charity of choice ... *

Please select ONE of the following ... *

I will submit donation, providing proof of receipt on or before the last day of the challenge I selected.

I will give money to Leanne Hintz, who will submit donation then provide proof of receipt on or before the last day of the challenge I selected.

I understand that by committing to this challenge, I am making a PROMISE to ME ... *CHECK ALL THAT APPLY* *

I am also willing to participate in the The Monthly Challenges Club in TEAMS or on FB (e.g. celebrate progress, encourage others, etc.).

I MAY find it difficult to post daily in The Monthly Challenge Club in TEAMS or on FB.

I hope to show up in TEAMS or on FB on a regular basis. I know this will be another way for me to stay accountable.

I would prefer to just "chat" with Leanne (or other participants) privately.

Other:

Required

Send me a copy of my responses.

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