Get Up & Go Participant Form
 Thank you for considering your role as a possible participant in the St. Clair County health and Fitness Campaign.  In the space below, please tell us about your group or Organization.

We would like to list your group or organization as a participating member.  All other information will be kept confidential and used for contact purposes only.*  Check out our Participating Groups so far.  Your group's name should be there too!!!

Name of Organization or Group:

City of Location:

Approximate Size (number of people):

Contact Name:

Telephone:

E-mail:

Please confirm your e-mail:

Health & Fitness Activity (If known):

Age Group:


I'm interested but currently undecided on our specific activity: 

Website Address: (optional)

Please tell us how you found our website:


Comments/Questions:


 

*  After the campaign period (April 1 through April 30, 2008) we would like to tally a report on the total number of groups and participants involved (i.e. 200 organizations and 6,000 individuals participated overall).  In order to accomplish this task, we will need to ask each participating group to give us an estimated count of those in their organization who participated.  Any results of individual groups or organizations submitted through this form will remain confidential and will not be publicly reported.


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