Print out this page and complete it as accurately as possible. Please type or print clearly.
Personal Info
First and Last Name:
________________________________________________________
Home Address:
City: _____________________ State: _____ Zip: _______ Country:___________
Daytime Phone #: (_____)____________ Evening Phone #: (____)___________
E-mail Address: _________________ Alternate E-mail Address: ________________
Date After Materials were completed*: ___________
*Should be 12 weeks from date Before Materials were completed. After Materials (After Entry Form, After Health Improvement Report, After Photos, and Essay) must be mailed within 5 days after testing is completed and photos are taken.
I hereby verify that all information and statements made in this application are true. I understand that if my application is incomplete, it will not be considered for judging. I also understand that my completed After Materials must be postmarked no more than 12 weeks after my Start Date, as outlined in the contest rules and regulations, to be considered for judging.
I agree that by submitting my application, I am transferring ownership of my photographs and essay to GHF to be used in accordance with the contest rules and regulations. I also agree that my name, photographs, and essay may be used to promote GHF's online membership program and future contests, without limitation, as provided in the contest rules and regulations. I am 18 years of age or older and competent to understand and abide by this agreement.
I have read and understood the rules and regulations of the GHF Fitness Challenge in their entirety. By signing below, I agree to abide by all rules, regulations, and requirements for competition in this contest.
Your Signature:__________________________________
Printed Name: ___________________________________
You must complete 2 of the 3 tests below. Click here for details on the special requirements for each test.
1. Body Composition
Age: ______ Weight:________
Skinfold measurements in millimeters (mm):
Click here for instructions and illustrations of skinfold measurement sites and the chart to use in determining your Body Fat Percentage, Fat Weight, and Lean Body Weight.
Body Fat % = ________
Fat Weight (Body Fat % x Scale Weight) = ________
Lean Body Weight (Scale Weight - Fat Weight) = ________
Name of person administering Body Composition Test*: ____________________
Credentials/Certifying Organization and # (e.g., ACE T29124): _______________
__________________________________________________
Signature of test administrator: ________________________________
Date test was administered**: ________
*Must be the same person as documented in your Before Health Status Report.
**Must be within 5 days of the After Materials postmark date.
2. Cholesterol Screening
LDL Cholesterol: ______ HDL Cholesterol: ______ Total Cholesterol: ______
Name of person administering Cholesterol Screening: ____________________
Credentials/Position: ______________________________________________
Signature of screening administrator: ________________________________
Date screening was administered**: _________
Click here for more information on Cholesterol Screening requirements.
3. Strength Test
Upper Body Strength Test (Choose A or B and fill in weight used):
A. Bench Press (Bb) One Rep Maximum_____lbs. 10 Rep Maximum ____lbs.
B. Bench Press (Db) One Rep Maximum_____lbs. 10 Rep Maximum ____lbs.
Lower Body Strength Test (Choose A or B and fill in weight used):
A. Squats (Bb) One Rep Maximum_____lbs. 10 Rep Maximum ____lbs.
B. Leg Press One Rep Maximum_____lbs. 10 Rep Maximum____ lbs.
Note: Bb = using a barbell Db = using a dumbbell 1 kg. = 2.2 lbs.
Name of person who spotted you while lifting*: ____________________
Your relationship with the spotter (check one)
a. Personal trainer:____ b. Gym staff:___ c. Workout partner:___ D. Other:_____
Signature of spotter (Spotter, please only sign if applicant used good, slow lifting technique): ________________________________
*Must be the same person as documented in your Before Health Status Report .
Click here for more info on Strength Testing requirements.
Please check one of the following:
I have enclosed 2 After Photos with this application (prints or on disk).
I have attached 2 digital After Photos to an e-mail message (send to info@global-fitness.com)
Date photos were taken**: ________
Click here for complete details on photo requirements.
Print out, complete, and include the following checklist when you send in your After Materials:
I have completed and included the entire After Entry Form, with name, address, city, state, zip code, e-mail, daytime and evening phone numbers, and the After Materials completion date.
I have affixed my signature, affirming that I have read and understood the Rules and Regulations of this contest and will abide by them.
I have included two (2) After Photos with appropriate date verification information as required. Click here for photo requirements.
I have completed my After Health Improvement Report, with documented evidence in at least 2 of the 3 categories (Body Composition, Cholesterol or Strength). I have documented the same two categories and have been tested by the same professionals as on my Before Health Status Report.
I am providing a typed 750-word Essay and affirm that I have written this myself. Your essay may be submitted on paper or on a disk enclosed with your materials or as an e-mail attachment mailed to info@global-fitness.com.
Mail completed After Materials* (photos and essay may be e-mailed) to Global Health & Fitness,12550 SE 93rd Ave., Suite 210, Clackamas, OR 97015. Entries must be postmarked with a date no more than 12 weeks from your Start Date, as outlined in the contest rules and regulations.
*"After Materials" = After Entry Form, After Health Improvement Report, After Photos, and Essay.
Important notice: Incomplete applications will be disqualified. We will do our best to notify you of any difficulties or missing items when possible, but GHF is not responsible for incomplete applications or late arrivals.
Questions? Email us at info@global-fitness.com. You'll get a prompt, detailed response within 24 hours.
