Registration Your login name will be created automatically as your first name plus your last name plus the last 4 digits of your phone number. For example: Jenny Smith's phone number is 867-5309. Her login name would be jennysmith5309. First Name: Last Name: Last 4 digits of phone number: 4 digit number (to be used as password): Email: retype Email: Gender: femalemale Age Group: < 1818-29 30-3940-4950-59> 60 Ethnicity: African AmericanAsianCaucasianHispanicNative AmericanOther Address Line 1: Address Line 2 (if applicable): City: State: SCNCGAOther Zip Phone: Height (feet) (inches) Personal Weight Goal Group / Company (optional): (optional) create new group Asten Johnson Avery Dennison Calvary Baptist Church Carolina First Commission of Public Works Eighth Circuit Solicitor's Office Evergreen greenville hospital system Hillcrest Baptist Church HIS Radio Biggest Losers Hospice of Laurens County ISO Poly Films KBR Laurens County 911 Laurens County DSS Laurens County EMS Laurens County Health Department Laurens County Hospital Laurens Electric LAURENS FAMILY PRACTICE/GREENVILLE HOSPITAL SYSTEM Laurens High School Laurens Mental Health Laurens Middle School LCDSNB LCWSC Presbyterian College PRTC United Way of Laurens County YMCA of Clinton YMCA of Laurens (Please check to see if your group, business, or organization is participating. You can also join later by updating your profile.) Team (optional): (optional) create new team AstenJohnson Calvary Baptist Church in Clinton SC Chunky Monkies Dendys DSS fam love Fat Free GRITS H T Losing Ladies Hospice of Laurens County Laurens Elementary School Laurens Mental Health Laurens middle / D.O. Lost Communications Lucky Losers mom and sons MOTIVATION The 3 T's The Hot Mamas The Pink Ladies United Way Whitten Center (Please check to see if your team is participating. You can also join later by updating your profile.) In addition to joining Activate South Carolina, you also have the opportunity to take part in a project to determine Activate South Carolina’s impact on body mass index and physical activity participation. Taking part in this project simply allows anonymous use of the information you enter on the Activate South Carolina website. There are no known risks for taking part in this study. Your participation is completely voluntary and in no way impacts your participation in Activate South Carolina. You have the right to withdraw from the study at any time without penalty. If you have any questions about this study, you may contact Dr. Alicia Powers of the Health and Exercise Science Department at Furman University (E-mail: alicia.powers@furman.edu; Phone: 864-294-3224). We are eager to have everyone participate in this project; however, if you do not wish to participate, please indicate below. I do want to participate in the project described above. I do not want to participate in the project described above, but understand I can still participate in Activate South Carolina. In submitting my entry, I for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I may have now or hereafter arising against the YMCA of Greenville, Greenville Hospital System, and Furman University, other YMCAs of South Carolina, North Carolina, and Georgia, and all sponsors and their employees, officers, directors, principals, agents, representatives, successors, and assigns, including but not limited to any and all claims of damages, injuries, demands, actions whatsoever, however they may occur, arising as a result of my participation directly or indirectly in said YMCA of Greenville programs. Furthermore, I hereby grant full permission to any and all of the foregoing to use my name, my voice, and/or picture in any broadcasts, telecasts, advertising, promotion or other account of this event for any purposes whatsoever without thought of remuneration. If under 18, parent’s signature required. I agree to the terms specified in the waiver
Your login name will be created automatically as your first name plus your last name plus the last 4 digits of your phone number.
For example: Jenny Smith's phone number is 867-5309. Her login name would be jennysmith5309.