The CORE Challenge
100 Days to win $10,000

REGISTRATION 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: ______________________________

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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 _____________________

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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 Here to Go Back to Core Challenge

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All Rights Reserved