Move More To Win Challenge Entry Form
Thank you for joining the "Move to Win More" Challenge. The goal of this challenge is to get you, your friends and family to get up and move more. If you will be walking in this challenge, try to walk 10,000 steps a day.

You don't have to use an activity tracking device to participate. If you aren't using an activity tracking device, you will need to track the amount of time you are being active daily. This can be done using an app on your phone, Microsoft Word, Microsoft Excel, etc. At the end of the week post your total activity to the Facebook Group or email them to lbxfitness1@gmail.com

If you aren't using an activity tracking device you will be track and submit your total activity in minutes at the end of each week.

If you are using an activity tracking device, you will submit your total numbers from your tracking device at the end of each week. Take a screen shot of your weekly totals and post them to the Facebook Group or email them to lbxfitness1@gmail.com

What is a tracking device: What is an activity tracker? It is a small, wearable, wireless sensor that tracks your actions throughout the day. A tracker can measure how many steps and how far you walk, how many calories you burn, and your “active” versus “inactive” minutes. Some activity trackers monitor how much and how well you sleep.

Trackers can be worn on your wrist, placed in a pocket or clipped onto a shoe or an article of clothing, like a belt, waistband or bra, or worn on a wristband, armband or as a pendant around the neck.

Examples of the different types of activity trackers:
* Apps (Android/iOS: Map My Walk, Nike, Virtual Walk, Endomondo, MapMyFitness, Accupedo, Runtastic Pedometer, Moves, etc.)
* Pedometers (only counts steps)
* Fitbit
* Garmin
* Misfit Flach Link
* Apple Watch
* Samsung Gear
* Polar
* TomTom
* Jawbone Up
* Moov Now

Start date: 5/1/17
End date: 6/11/17

This is a 6 week challenge

Entry Fee $5

After you make your payment, you will be added to the Facebook Group: Move More to Win Challenge, if you are on Facebook, if not you will receive weekly email reminders.

You don't have to have a Facebook account to participate in this challenge. You can participate and not have a Facebook account.

Email address
First name
Your answer
Last name
Your answer
Phone number
Format: 704-999-0987
Your answer
Age (must be 18+ to participate)
Race
Sex
Where do you live?
What type of exercises are you currently doing? (select all that apply)
If you choose Other above, what other fitness activities do you participate in?
Your answer
If you are using or plan to use an activity tracking device, which one do you use below?
If you are or will be using an app, which one will you be using to track your activity?
Your answer
Entry Fee $5
After submitting your form, the next screen will provide you with a link to pay the entry fee of $5 (if you haven't paid the entry fee). You must pay the entry fee to participate. A portion of the entry fee will be giving to the winners of each category. The more people that sign up the larger the winning prizes will be. Invite your friends, family and coworkers to participate.
When will you pay the $5 entry fee?
Rules and Regulations
Who can participate: Anyone 18+

Rules (read full rules and regulations):

Must be 18 to participate. You can live any place in the world to be a part of the challenge.
Must fill out an entry form
The winners of each category will split 50% of the pot.
There are multiple categories. We want everyone to participate in this challenge. Due to everyone not being at the same fitness level, we have created different categories.
You will need a fitness tracking device. If you don't have a fitness tracking device, please download an app to your phone.
Each week you will submit your activity via Facebook by posting an image of your activity or sending your activity through email to lbxfitness1@gmail.com
You must be honest when submitting your activity and you aren't using a tracking device..
This is an individual challenge but invite your friends, family and coworkers to participate.

Rules & Regulations:

Entry. MOVE MORE TO WIN CHALLENGE - to participate pay the $5 entry fee, complete the sign up form and log your activity daily or weekly. All entries must be received weekly in order to be eligible. By entering this contest, you are opting-in to becoming a member of our e-mail newsletter database, meaning you will receive our Newsletter once a month, or similar. This e-mail newsletter database is used strictly by Leading by Example, LLC and will not be sold or re-distributed in any way. In the event you win, you allow Leading by Example to use your name and likeness in marketing and promotional materials. Leading by Example, LLC ("Sponsor") will not be responsible for incomplete, lost, late, misdirected or illegible entries or for failure to receive entries due to transmission failures or technical failures of any kind, including, without limitation, malfunctioning of any network, hardware or software, whether originating with sender or sponsor. In the event of a dispute, all email entries will be deemed to have been submitted by the owner of the email account from which they were sent. For these purposes, an email account holder shall mean the natural person assigned to such email account by the Internet access provider, online service provider or other organization responsible for assigning email addresses for the domain associated with such email account. Any questions regarding the number of entries submitted or the owner of an email account shall be determined by Sponsor in its sole, reasonable discretion, and Sponsor reserves the right to disqualify any entries by persons determined to be tampering with or abusing any aspect of the Contest.
Drawing Date, Prizes and Odds. Each winner will receive a portion of the pot and the book Who Needs a Gym? Using Social Media For Weight Loss. Odds of winning depend on the number of eligible entries received.

Winner Notification and Acceptance. Winners will be notified by return email during the duration of the contest. Winners have 10 days to respond to the email and claim the prizes. Return of prize notification as undeliverable may result in disqualification and an alternate winner may be selected. Winners may waive their right to receive a prize. Prizes are non-assignable and non-transferable. No substitutions allowed, except that prizes and individual components of prize packages are subject to availability and Sponsor reserves the right to substitute prizes of equal or greater value.
Winners are solely responsible for reporting and payment of any taxes on prizes.

Winners may be required to complete an affidavit of eligibility, and a liability and publicity release (except where prohibited by law) which must be returned within ten (10) days of date of postmark. Failure to sign and return the affidavit or release within ten (10) days, or to comply with any term or condition of these Official Rules, may, at the sole discretion of Sponsor, result in a winner's disqualification, the forfeiture of his or her interest in the prize, and the award of prize to an alternate winner.

Participation. By participating, entrants agree to be bound by these Official Contest Rules and the decisions of the judges. Sponsor reserves the right to disqualify persons found tampering with or otherwise abusing any aspect of this Contest as solely determined by Sponsor. In the event the Contest is compromised by a virus, non-authorized human intervention, tampering or other causes beyond the reasonable control of Sponsor which corrupts or impairs the administration, security, fairness or proper operation of the Contest, Sponsor reserves the right in its sole discretion to suspend, modify or terminate the Contest. Should the Contest be terminated prior to the stated expiration date, Sponsor reserves the right to award prizes based on the entries received before the termination date.

Limitations of Liability. By entering the Contest, entrant agrees that (1) any and all disputes, claims, and causes of action arising out of or in connection with the Contest, or any prizes awarded, shall be resolved individually without resort to any form of class action; (2) any claims, judgments and awards shall be limited to actual out-of-pocket costs incurred, including costs associated with entering the Contest, but in no event attorney's fees; and (3) under no circumstances will any entrant be permitted to obtain any award for, and entrant hereby waives all rights to claim, punitive, incidental or consequential damages and any and all rights to have damages multiplied or otherwise increased and any other damages, other than damages for actual out-of-pocket expenses.

Construction. All issues and questions concerning the construction, validity, interpretation and enforceability of these Official Contest Rules, or the rights and obligations of any contestant and Sponsor, shall be governed by, and construed in accordance with the laws of North Carolina without giving effect to any choice of law or conflict of law rules or provisions (whether of North Carolina, or any other jurisdiction) that would cause the application of the laws of any jurisdiction other than North Carolina. The invalidity or unenforceability of any provision of these rules shall not affect the invalidity or unenforceability of any other provision. In the event that any such provision is determined to be invalid or otherwise unenforceable, these rules shall be construed in accordance with their terms as if the invalid or unenforceable provision was not contained therein.

General Release. By entering the Contest, contestants release Leading by Example, LLC, any other promotional sponsors, and each of their respective affiliated companies, directors, officers, employees, representatives, partners and agents from any liability whatsoever for any claims, costs, injuries, losses or damages of any kind arising out of or in connection with the Contest or with the acceptance, possession or use of any prize (including, without limitation, claims, costs, injuries, losses or damages related to personal injuries, death, damage to, loss or destruction of property, rights of publicity or privacy, defamation or portrayal in a false light).

Sponsor. The MOVE MORE TO WIN CHALLENGE is sponsored by Leading by Example, LLC, whose decisions regarding the selection of winners and all other aspects of the Contest shall be final and binding in all respects. Sponsor will not be responsible for typographical, printing or other inadvertent errors in these Official Contest Rules or in other materials relating to the Contest. If you have any questions regarding this Contest, please contact Leading by Example, LLC, P.O. Box 669661 Charlotte, NC 28226

At any time during the challenge we can ask you for proof of your activity.

Agreement
By signing my name below, I certify that I have read the above information. My signature certifies my understanding of and agreement with the rules and regulations of the challenge.
Your Signature (digital) After clicking Submit, the next screen will have a link to where you will submit your $5 payment.
Your answer
Date
MM
/
DD
/
YYYY
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms