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* 1. Name

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* 2. Email 

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* 3. Are you signed up for the walk to Milton?

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* 4. Are you signed up for the move more than the Mayor challenge?

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* 5. Timeframe reporting for

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* 6. Steps, active minutes, or distance (KM or miles) Please specify which. (please include your totals here)

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* 7. Please check off what events you are interested in attending.

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