Walk Across Tennessee Individual Registration

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Each team member must complete the individual registration.

Your First and Last Name *

Your Email Address *

Your Phone Number *

Your Team Name *

Age *

Gender *

Female

Male

Prefer not to say

Ethnic Background *

Asian or Pacific Islander

Black/ Not of Hispanic Origin

Hispanic

American Indian/ Alaskan Native

White/ Not of Hispanic Origin

Prefer not to say

Other:

Your Personal Goals for Walking *

Reduce Stress

Control blood pressure

Drink more water

Reduce screen time

Improve sleep

Improve blood sugar levels

Lose weight

Other:

T-shirt Size *

XXL

XXXL

I wish to participate voluntarily in the Walk Across Tennessee physical activity for the purpose of personal fitness. I understand that I should have medical approval from my health care professional if I: • have any chronic health problems such as heart disease or diabetes. • have pains in my heart and/or chest areas. • have a bone or joint condition, like arthritis, that might be made worse by an exercise program. • have been told by a doctor that I have high blood pressure. • have any physical conditions or problems that might require special attention in an exercise program. • am a male over 45 or a female over 50 and not accustomed to vigorous exercise. I agree to accept full responsibility for any injuries I may sustain while participating in this program. *

Yes, I agree to accept full responsibility for any injuries I may sustain while participating in this program.

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