Game On! Week 5 Participation Question Title * 1. Full Name Question Title * 2. Rate your success in completing this week's small steps. Very high High Moderate Low Very low Nutrition Nutrition Very high Nutrition High Nutrition Moderate Nutrition Low Nutrition Very low Physical Activity Physical Activity Very high Physical Activity High Physical Activity Moderate Physical Activity Low Physical Activity Very low Question Title * 3. Did you use the tracker or a mobile app to record/journal your progress? Yes, the tracker Yes, a mobile app No If you answered "Yes, a mobile app," please specify the app's name Question Title * 4. Share a tip that helped you complete the challenge. (Optional) Question Title * 5. Can we share your tip in the Game On newsletter or webpage? Yes and you may include my name Yes but please make it anonymous No Question Title * 6. If you win the weekly prize, can we include your name in the prize announcement email? Yes No, please keep my name anonymous and email me to let me know I won. Done