BreatheStrong+ Fitbit Grant Request

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This is an application for a Fitbit from BreatheStrong CF and BreatheStrong+. BreatheStrong+ will provide an age appropriate device unless otherwise requested. We are currently sending out Fitbit Charge 6 for adults and Fitbit Ace 3 for children.

To be eligible for a FitBit, you must already be registered for BreatheStrong+.

We are unable to ship outside of the US.

Have you registered for BreatheStrong+? *

yes

First Name Last Name *

Parent Name (if applicable)

Age *

Email Address *

Street Address (include Apt # if applicable.) *

City *

State *

Zip code *

If granted a Fitbit, I agree to connect it to Charity Footprints for BreatheStrong+ participation. This is for those who receive an adult Fitbit. *

Yes

n/a I have requested a children's Ftibit

If granted a Fitbit, I agree to use it to benefit my fitness (or my child with CF's (if a parent)), and will not gift, trade, sell or use for any other purpose. *

Yes

Acceptance of a Fitbit from BreaatheStrong+ and BreatheStrong CF is a commitment to connect the device to Charity Footprints. Failure to connect the device can impact your eligibility for grants in the future. *

I understand

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