Name * First Name Last Name Phone * Email * T shirt size (if a weekly prize is shirt) Small Medium Large X Large 2 X Large 3 X Large Optional Weight Loss Cash Prize * I am including $10.00 to enter the optional weight loss cash prize portion of the challenge. Yes No (Payments made via cash, check or card to Dallas County Health Department, on or before initial weigh-ins March 28, 2025) Disclaimer Disclaimer: I understand that I must weigh in weekly on the assigned days to be eligible for prizes offered. I realize that any attempt to manipulate the weights would result in automatic disqualification at the discretion of the sponsors. Only safe and approved methods for weight loss are encouraged. Individuals utilizing non-prescription weight loss enhancing methods are ineligible for the weight loss portion of the challenge. If you have any underlying medical conditions or have never started a weight loss program we encourage you to seek a doctor’s advice prior to beginning the program. The sponsors of this challenge are not responsible for any health related issues that might arise as a result of participation. The goal of this contest is to promote community wellness and encourage healthy behaviors. All results will be final and are indisputable. Thank you!