FIT for FUNDS

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TEAM REGISTRATION

Thank you for taking the challenge! Please complete the information below to register your team.

Clinic Information

Clinic Name:

Street Address:

City:

State:

Zip:

Team Contact

Name:

Phone:

E-Mail:

Team Charity

Charity:

Team Weight Loss Goal:

(Bledsoe will donate $1 for every pound lost, up to one ton!)

Teammates

Name:  E-Mail:

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Please Note: This program is open to Orthopedic Clinics only and must be executed in conjunction with the local Bledsoe Sales Representative. Your sales representative will provide you with the tools and help you track your team's progress.