Move. Polk County 2021

Interest Form & Sign-Up

Thank you for your interest in participating in Move. Polk County 2021!

Move. Polk County is hoping to encourage all and everyone to get their MOVE ON to a healthier lifestyle this summer. We know how important it is to get out and be active & regular movement helps our body, mind and spirit!

Just 30 minutes of activity a day can help reduce stress, increase energy levels, boost mood, improve sleep, maintain a healthy body weight and build healthy muscles.

Ready to start the challenge? Sign up to receive weekly motivational e-mails to keep you on track and moving.

Question Title

* 1. Sign Me Up for Move. Polk County

Name

Company (If Applicable)

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. How would you prefer to receive your maps?

Pick-up

Download from website

Other (please specify)

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* 3. How would you like to submit your maps?

Fax

Mail

Drop off at Public Health Office

Other (please specify)

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* 4. Would you like to sign up for weekly motivational emails?

Yes

Insert Email Here (if different from above)

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* 5. Are you interested in receiving information on Polk County trails?

Yes

Insert Email Here (if different from above)

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* 6. Please share with us how you learned about Walk Polk County?

Family/Friend

Media Source

Polk County Public Health

Particpated in past years

Other (please specify)