Registration for the Walkathon organized by the Indian Society of Lifestyle Medicine
Date: 4th March 2023
Time: 5.30 AM
Venue: Outside Cozee on Eliots Beach, Besant Nagar, Chennai

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Name *
Age *
Gender *
Location *
ISLM member *
Do you participate in regular exercise?
 *
Have you been diagnosed with any medical condition?
Medical conditions include but not limited to Asthma, Hypertension, Cardiovascular disease & Diabetes
 *
Are you on any medications currently?
 *
Phone number *
E-mail ID *
Distance you are comfortable walking (over 3 days)
 *
Name of the app used to track the distance.  (Recommended app: Strava)
 *
I agree to the following terms and conditions.
Event organizers assume no responsibility for anyone participating in the event.                                                     Event organizers will not be held responsible for any accident ,injury or loss occurring as a result of the event however caused.                                                                        I agree to share my walkathon images with the organizers and for them to be used by ISLM to promote the message ’Movement is Medicine’.
 *
Required
I have read the instructions on preparation & warm-up for the walkathon. Details for which are found under:
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Please check with your Physician before participating if you are over 40 or  have any other health conditions
 *
Required
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