This collector is now closed
*
indicates required
Name:
Email:
Comment:
Email address
*
An email address can only be used once. Family members will have to submit different ones.
Phone number
Office use only - have they paid
Paid and emailed
Not Paid
FREE
Paid and not emailed
PULLED OUT
PT ONLY CATEGORY
Be in to win more! Tick any that are applicable
TEAMS - tick this one if you're keen to join in on the team challenges
COUPLES - your partner (by marriage or de-facto) is signing up too
BUDDY - your friend is signing up too and you're going to support each other
OPALS - for entrants 65 and over as at June 30th, 2017.
YOUTH - for entrants 16 and under as of October 1, 2017
NEW MUMS - if you've had a baby in the last 24 months prior to May 1st 2017.
WORKPLACE ANGEL - take on the challenge of making life at work healthier
EARLY STARTERS - your chance to be acknowledged for your pre-challenge efforts
PETS & PEEPS - get fit with your pet :-)
Can we consider you for these Awards? Tick if yes.
OVERALL ENTRANT- for those who embrace the 20 Week Challenge and give it their all.
OVERALL BODY CHANGE - acknowledges changes in shape, strength, fitness - the whole kit & kaboodle!
LIFESTYLE - for an entrant who has made positive changes to their lifestyle during the 20 weeks
