Please provide your first and last name:

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* 1. Please provide your first and last name:

Where do you work?

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* 2. Where do you work?

Please provide a phone number to reach you (for prizes!):

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* 3. Please provide a phone number to reach you (for prizes!):

Week of Challenge

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* 4. Week of Challenge

Saturday Physical Activity Minutes

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* 5. Saturday Physical Activity Minutes

Sunday Physical Activity Minutes

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* 6. Sunday Physical Activity Minutes

Monday Physical Activity Minutes

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* 7. Monday Physical Activity Minutes

Tuesday Physical Activity Minutes

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* 8. Tuesday Physical Activity Minutes

Wednesday Physical Activity Minutes

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* 9. Wednesday Physical Activity Minutes

Thursday Physical Activity Minutes

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* 10. Thursday Physical Activity Minutes

Friday Physical Activity Minutes

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* 11. Friday Physical Activity Minutes

What type of activities did you perform for physical activity this week?

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* 12. What type of activities did you perform for physical activity this week?

Did you increase your level of physical activity this week?

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* 13. Did you increase your level of physical activity this week?

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