Walk Across Texas!
Family Development and Resource Management, Family and Consumer Sciences, Texas AgriLife Extension Service, The Texas A&M University System

By Yourself Registration
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Choose your County:
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Enter Your City/Town:
(i.e. Houston)
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Walker's 5 Digit Zip Code:
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Password:
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Walker's Gender:
Female    Male 		required information
Walker's Age:
years
Walker's Ethnic Background:
Anglo African-American Asian
Hispanic Native American Other (specify)  
I wish to participate voluntarily in Walk Across Texas.   I agree to accept full responsibility for any injuries while participating in this program.  I agree to check with my doctor before I start if I have any physical conditions or problems that might require special attention and/or if I am a male over 45 years old or a female over 50 years old.
Yes                  No
Which of these fitness activities do you do now? (Check all that apply.)
A. I do no fitness activity now. D. Swim
B. Walk E. Ride bicycle
C. Run F.  Other (specify)
If you do a fitness activity now, please indicate how many days each week you perform the activity(ies) checked above.
A. Walk days each week. D. Ride days each week.
B. Run days each week. E. Other activity days each week.
C. Swim days each week.
Indicate the number of minutes each day you perform the activity(ies) checked above.
A. Walk minutes each day. D. Ride minutes each day.
B. Run minutes each day. E. Other activity minutes each day.
C. Swim minutes each day.

 

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Educational programs of the Texas AgriLife Extension Service are open to all people without regard to race, color, sex, disability, religion, age, or national origin.

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