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Register for the
The Mount Kilimanjaro
Take the Stairs Challenge
!
Winter 2020
To register for
The Mount Kilimanjaro Take the Stairs Challenge
, please take a few minutes to complete this survey:
OK
*
1.
Please provide the following information:
(Required.)
Name:
Uni:
Columbia University Email:
2.
Please indicate the extent you agree or disagree with the following statement:
I want to join
The Mount Kilimanjaro Take the Stairs Challenge
in order to...
Strongly Agree
Agree
Disagree
Strongly Disagree
Manage my weight
Strongly Agree
Agree
Disagree
Strongly Disagree
Increase my energy level
Strongly Agree
Agree
Disagree
Strongly Disagree
Improve my fitness level
Strongly Agree
Agree
Disagree
Strongly Disagree
Feel more healthy
Strongly Agree
Agree
Disagree
Strongly Disagree
Feel more positive
Strongly Agree
Agree
Disagree
Strongly Disagree
Other (please specify)
3.
In the past month, how often did you choose the stairs over the elevator while you were at work?
Never
Rarely (less than once a week)
Sometimes (once a week or more)
Often (once a day or more )
Varies
4.
Team Registration Information: (
Remember, there are 4-5 participants per team; if you have not identified a team, please leave this section blank and you will be assigned to a team
)
What is your
team name
?
What is the name of your
team captain
? If you are the captain, write your own name.
5.
Please share any comments below:
Thank you! Best of luck in
The Mount Kilimanjaro Take the Stairs Challenge
!
For questions or comments please contact Daniela Elazari, Wellness Manager, at dn2384@columbia.edu.