March 10 - May 2, 2008

Physical fitness “get healthy” initiative

Register Today!

Step 1: How to Register

• Register on-line (below) Or mail in your registration card.
• FREE registration entitles you to special gifts and other incentives in your registration confirmation packet. (Packets to be picked up at kick-off program).
• Special awards at Wrap-up for Minutes active achieved.

Step 2: Record Minutes Active

• Log on weekly to record your minute’s active at move.lunginfo.org Or fill out Log Sheet and fax in results weekly.
• Every minute counts toward achieving our goal of 12 million minutes!
• Any activity will do, walking, running, biking, gardening, dancing, etc.

Step 3: Keep Informed

• Watch for special fitness & nutrition programs in your area.
• Tune in to WARM 103 every Monday morning for latest information.

 

Registration Form

* = required

Login

First Name

Last Name

Company

Address

Suite/Apt

City

State

Zipcode

Phone

Email

Password

Confirm Password

Team Member

Team Name

Waiver:

In submitting my entry, I , for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I may have now or, hereafter arising against the American Lung Association of Pennsylvania or others sponsors and their employees, officers, directors, principals, agents, representatives, successors and assigns, including but not limited to any and all claims of damages, injuries, demands, actions, whatsoever, however, they may occur, arising as a result of participation in said Movers & Shapers program.

Further, I hereby grant full permission to any and all of the foregoing to use my name, my voice, and/or my picture in any broadcast, telecast, advertising, promotion or other account of this event for any purposes whatsoever.

I agree To the above waiver

Name of parent/guardian if under the age of 18