Roper Hospital Wall Sit Challenge Registration

Roper Hospital Wall Sit Challenge

Congratulations on deciding to participate in our second Roper Hospital Wellness Challenge!

The challenge is to remain in the wall sit position (back against the wall, knees parallel to the floor) for five minutes, but we want you to participate even if you can't stay in that position the entire time.

We've got some surprise prizes and give-aways.

We look forward to seeing you there!

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* 1. If you'd like to enter the Roper Hospital Wall Sit Challenge, please enter your name and department.

Name

Department

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* 2. Please guess-timate how long you will wall sit:

I can wall sit until you make me stop.

Five minutes

Four minutes

Three minutes

Two minutes

One minute

If I can wall sit for longer than five seconds, I'll be proud of myself.

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* 3. Please indicate your t-shirt size.

Men's Small

Men's Medium

Men's Large

Men's Extra Large

Men's 2XL

Women's Small

Women's Medium

Women's Large

Women's Extra Large

Women's 2XL

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* 4. I plan to participate:

As an individual

As part of a team

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* 5. We will have a Team Spirit Award. If you are participating on a team, please list your five team members' names and team name below. Only one person from your team needs to fill out this registration form. If you are participating as an individual, you can skip this question.

Team name:

Team member 1:

Team member 2:

Team member 3:

Team member 4:

Team member 5:

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* 6. Please enter your email address below so we can contact you with important updates/additional information for the challenge. If you are entering on behalf of a team, either: 1. Write the email address for every person on your team or 2. Know that only you will be receiving updates on the Ultimate Wall Sit Challenge and you will be responsible for sharing those with your team.

FOR INDIVIDUALS: My email address is

FOR TEAMS: Email address for team member 1

FOR TEAMS: Email address for team member 2

FOR TEAMS: Email address for team member 3

FOR TEAMS: Email address for team member 4

FOR TEAMS: Email address for team member 5