The
CORE Challenge
100 Days to win $10,000REGISTRATION
FORM
Firts Name:___________________________ Last
Name:_____________________________
Birth
Date:______________ Gender:_______________ Current Weight:______________ Address:__________________________________________________City________________ State/Prov.:_______________________________________________ZIP/Postal____________ Home
Phone:_______________________ Work Phone:_____________________ Email
Address:______________________________________________________ Ocupation:__________________________________________________ Competitor's
Signature: ______________________________ ****************************************************************** The
foregoing registration was acknowledged before me this _____ day of
____________________, 20____ by __________________________________
[YOUR
FULL LEGAL NAME], who is personally known to me for __________ years. Witness'
Signature: _________________________________ Witness
Telephone Number: _________________________ Dated
_____________________
******************************************************************* Please
register by: - Faxing this REGISTRATION
FORM to (604) 642-6231
- Mailing this
REGISTRATION FORM to:
OK Initiatives, Inc.
2543 2nd West Avenue
Vancouver, B.C.
V6K 1J7, Canada IMPORTANT:
Make sure you pay your registration online.
Click
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