Healthy Heart Month Prize Draw Question Title * 1. Name Question Title * 2. Is the entrant a service user or staff member? Service User Staff Member Question Title * 3. Contact Name (if different) Question Title * 4. Contact Email Question Title * 5. Would the entrant like to be entered into the prize draw for a chance to win a Smart Watch? Yes No Question Title * 6. Does the entrant consent to having their name and photographs shared publicly? Yes No Question Title * 7. Has the entrant chosen to try three different types of exercise or raise money for British Heart Foundation? Exercise Raise money Question Title * 8. If exercise, please write down the three different types of exercise. 1. 2. 3. Question Title * 9. If raise money, what did the entrant do? Question Title * 10. Please upload photos of the entrant trying three different exercises or evidence that the entrant has raised money for British Heart Foundation. Please ensure you have taken the highest quality picture you can, with good lighting. PDF, PNG, JPG, JPEG file types only. Choose File Choose File No file chosen Remove File Please upload photos of the entrant trying three different exercises or evidence that the entrant has raised money for British Heart Foundation. Please ensure you have taken the highest quality picture you can, with good lighting. Question Title * 11. Additional Photo PDF, PNG, JPG, JPEG file types only. Choose File Choose File No file chosen Remove File Additional Photo Question Title * 12. Additional Photo PDF, PNG, JPG, JPEG file types only. Choose File Choose File No file chosen Remove File Additional Photo Question Title * 13. Any other information about your exercise activities or fundraising. Done
