Exit this survey >> Inter Agency Greatest Loser Final 2017 - San Bernardino County 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. Question Title * 2. Team Captain name and contact information (please use your work information NOT your personal information): Name: Work Email: Work Address: City, State, Zip: Work Phone Number: Question Title * 3. Please enter the employee names of all the participants on the team (start with the Team Captain) 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 * 4. Team Name:(Enter the same name selected during registration for your team, your team name stays the same during the entire contest, i.e. Biggest Loser, Gut Busters, etc.). Question Title * 5. 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). 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Question Title * 6. Total team weight during the week of March 27th - April 2nd, 2017. :(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 last weight. Done >>