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Format: (000) 000-0000.
- Which most closely describes your gender identity?*
- Which racial or ethnic group(s) do you identify with? (Select all that apply)*
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- Residential Address*
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- Which best describes where you are in your movement journey right now?*
- Which best describes your current overall activity level?*
- Select the top barriers to participation in movement or wellness activities you have experienced (select all that apply)*
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- Within a structured fitness program, what level of support are you most interested in?*
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- Are you willing to commit to a consistent movement program for 6 months, including regular use of the awarded services each month? We’re looking for participants who intend to engage meaningfully and build a routine over time.*
- We understand that transportation can be a barrier to movement; however, this program is not able to provide transportation support at this time. Participants are responsible for securing reliable transportation to and from their selected training facility. Please confirm that you are able to do so and have verified the location of your preferred vendor(s).*
- Do you have access to a smartphone? This is not required to participate in the program.*
- Do you have a Strava account? This is not required to participate in the program.*
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- Should be Empty: