Finding Balance Campaign, November 2018 - Be Active Challenge Kit - ORDER FORM
Thank you for your interest in the Be Active Challenge Kit! Complete this form to receive a toolkit of materials to support you and your participants in the Finding Balance Be Active Challenge! If you have any questions or comments, please contact ipc@ualberta.ca

As a group leader, you will:
1.Register your group to participate by submitting this form.
2.Receive a tool kit from IPC.
3.Track the minutes of activity and the number of days participants engage in strength and in balance activities (Tracking sheet included in the kit).
4. At the beginning AND end of November, ask your participants their perceived level of strength and level of balance.(Tally form and survey questions included in the kit)
5. Submit all results (total minutes of activity, number of days of strength and balance activities and the survey results) to IPC through a link on the Finding Balance website.

You can download all the Finding Balance campaign resources from:
http://findingbalancealberta.ca/resource-catalogue/

First Name *
Your answer
Last Name *
Your answer
Organization *
Your answer
Mailing Address *
Your answer
Town/City *
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Province *
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Postal Code *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
In total, how many seniors do you expect to participate? *
Your answer
To participate in the Finding Balance Be Active Challenge 2018 and receive a took kit, I agree to the following: *
Agree
Through November, track the number of participants, their minutes of activity and the number of days strength and balance activities occurred.
At the beginning AND end of November, ask your participants their perceived level of strength and level of balance.
Send all results to IPC at the end of the month through a link on the Finding Balance website
Provide feedback to IPC on this kit
To order more resources, please visit: http://findingbalancealberta.ca/resource-catalogue/
If you have any questions or comments, please contact ipc@ualberta.ca.

Thank you for joining the Challenge!

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