2018 Registration for San Bernardino County
Competing with County of Los Angeles and Metropolitan Transportation Authority

RSVP

Registration Below:

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

Question Title

* 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 Full Name:

Team Captain Employee Number:

Work Email:

Work Address:

City, State, Zip:

Work Phone Number:

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* 3. Team Name:
(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 number of team members you start the campaign will stay the same throughout campaign.
(Select the number of team members on your team which includes the team captain from the drop-down list, 1-15).

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* 5. Total team weight during the Registration week January 22nd - January 28, 2018 :
(Enter the total number of pounds your team weighs. Refer to your tracking template).

If a member of your team at some point drops out, then in future weigh-ins please just include and roll over his/her initial weight.

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* 6. Please enter team members' name (start with the Team Captain). Also, you will need to provide employee numbers for these members during the final weigh out, the week of March 26th - April 1nd, 2018.

Team Captain

Participant 2

Participant 3

Participant 4

Participant 5

Participant 6

Participant 7

Participant 8

Participant 9

Participant 10

Participant 11

Participant 12

Participant 13

Participant 14

Participant 15

Question Title

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

Question Title

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

Question Title

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

Question Title

* 4. Number of Team Members:The number of team members you start the campaign will stay the same throughout campaign.(Select the number of team members on your team which includes the team captain from the drop-down list, 1-15).

Question Title

Question Title

* 6. Please enter team members' name (start with the Team Captain). Also, you will need to provide employee numbers for these members during the final weigh out, the week of March 26th - April 1nd, 2018.

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

* 4. Number of Team Members:
The number of team members you start the campaign will stay the same throughout campaign.
(Select the number of team members on your team which includes the team captain from the drop-down list, 1-15).