Capitol Wellness Walk Sign Up
The Foundation for Black Women's Wellness is a Wisconsin based non-profit organization committed to 'Empowering a Generation of Well Black Women'. Our mission is to energize, mobilize and support Black Women to transform their lives through education, advocacy, and powerful partnerships.

Thank you for your interest in joining our weekly Capitol Wellness Walks on Wednesdays, 12:15pm CST.

Walks will be led by FFBWW Walk Captains. Walkers will meet at the following location at 12:15pm SHARP: Capitol Building Rotunda.

Please complete the following questions to confirm your participation.

*Note: By joining our voluntary Capitol Walks, you are indicating that you have consulted your health care provider and confirmed that you are physically able to walk with us without risk or threat to your health.

Be sure to click SUBMIT after completing all questions.


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Email *
First & Last Name *
What is your date of birth? *
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Cell Phone number *
City *
State *
Zip Code *
What is your race/ethnicity? Please check all that apply. *
Required
Is this your first time joining our Capitol Wellness Walks? *
How did you hear about the Capitol Wellness Walks? *
Why are you interested in joining our weekly Capitol Walks? *
Do you live or work downtown? *
If you work downtown, who is your current employer?
What is your connection or involvement with the Foundation for Black Women's Wellness (FFBWW)? *
Please select which fitness apps, if any, you use to track your fitness activity. *
Required
Please indicate which social media platforms you are  active on: *
Required
Provide LinkedIn handle if you have an account:
Are you willing to enter and share your daily and/or weekly steps into a tracking form for FFBWW so that we can monitor your walk progress as a part of our health impact data? *
Do you want to receive a Google calendar invite for 2021 Capitol Walks? *
Are you interested in learning more about being a Wellness Walk Captain in or near your neighborhood? *
I understand that participation in the Foundation's Capitol Wellness Walks is 100% voluntary. By signing-up and participating, I confirm that I have consulted my physician or healthcare provider and that I am cleared for physical activity. I also understand and agree that 1) I am participating at my own risk, 2) I am required to wear a mask and to follow the safe social distancing requirement of 6ft between walkers, and that 3) I will not hold the Foundation for Black Women's Wellness or any of its agents or representatives liable for any injury, illness, or damages I incur as a result of my voluntary participation. *
Come stroll with us downtown every Wednesday, 12:15pm!
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