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Mid point 2018 - San Bernardino County

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Inter Agency Greatest Loser Mid Point 2018 - San Bernardino County

Disclaimer: your response will be shared with a 3rd party and employer in order to administer an incentive.

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* 1. Please enter your department's name below.

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* 2. Team Captain name and contact information (please use your work information NOT your personal information):

Team Captain Name:

Team Captain Employee ID:

Work Email:

Work Address:

City, State, Zip:

Work Phone Number:

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* 3. Team Name:
(The same name selected at registration, team name will stay the same during the contest, i.e. Biggest Losers, Gut Busters, etc.).

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* 4. Number of Team Members:
The team must be the same number of team members you started the campaign with.
(Select the number of team members on your team from the drop-down list, 1-15).

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* 5. Total team weight during the week of February 26th - March 4th, 2018
(Enter the total number of pounds your team weighs. Refer to your tracking template).

If a member of your team did not weigh-in or dropped out, then please include and roll over his/her initial weight.