JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Get Up In Glencoe
This is where you will initially
register
for the walking challenge. This will also be where you
record your weekly step amount
. Come back at the end of each week, tally your steps, and record them on this form.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Brought to you by:
First and Last name?
*
Your answer
Phone Number?
*
Your answer
Email?
*
Your answer
If you are selected as a winner of a prize, would you prefer to get emailed or called about your prize?
*
Please call
Please email
Are you an adult or someone who is 17 and under?
*
Adult
17 or under
Week 1 Total Steps
Your answer
Week 1 -If you have a child (children) under 17 to report on, please include their name and number of steps or number of days active.
Your answer
Week 2 Total Steps
Your answer
Week 2 -If you have a child (children) under 17 to report on, please include their name and number of steps or number of days active.
Your answer
Week 3 Total Steps
Your answer
Week 3 -If you have a child (children) under 17 to report on, please include their name and number of steps or number of days active.
Your answer
Week 4 Total Steps
Your answer
Week 4 -If you have a child (children) under 17 to report on, please include their name and number of steps or number of days active.
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
