I Will Commit 2025

I Will Commitment

Review the three areas of focus below, learn how you can choose to be fit, lower your risk, be your best weight, and reduce stress within each. Complete the form by choosing one area you'd like to focus on for 2025. Submit the form and you're on your way to a year filled with great tips, tools, and encouragement.
Which area of focus would you like to work on in 2025?*

How We MoveWhat We EatThe Way We Live
What is one small step you can take today to support your I WILL Commitment?*

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Name*

First NameLast Name
Email*
example@example.com
City, State*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How did you hear about us?*
Are you a Providence employee?*

YesNo
Optional Demographic Information

Would you consider helping us continue to offer, improve, and enhance our free community classes and programs? This demographic information will help us improve our ability to serve our participants, enhance funding, and perform research around healthy lifestyle behaviors and our community-centered programming. All research data will be de-identified. We do not sell or give your information to third parties.
Would you mind answering our demographic questions?*

Happy to answer!No thanks.
Age
What race(s) do you consider yourself to be?

Alaska NativeAmerican IndianAsianBlack/African AmericanNative Hawaiian/Other Pacific IslanderWhite/CaucasianSome other racePrefer not to sayUnknown
Do you consider yourself to be Hispanic or Latino?
How do you identify?

ManNon-binaryWomanPrefer to self-describe
PARTICIPANT WAIVER

Please read the information below and then check the box indicating your understanding.
By checking the box below, you understand the following: I understand my name will be added to the Basecamp Prevention + Wellness contact list to receive information related to health and wellness. We do not share our database with outside groups.
Participant Waiver Acknowledgment*

I understand
If you have questions or comments regarding this registration or your I Will Commitment, please send us an email.
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I Will Commitment

PARTICIPANT WAIVER