Wellness Incentive Program

Please record your monthly exercise by completing the form below.   You are asked to select the month of record as well as the total number of days exercised/month. Your information will be recorded and a monthly winner will be drawn at random.   The winner will receive a wonderful prize as well as recognition in the Cuesta Newspaper. Thank you for your participation in the program and have fun.

Name:

Month to record:

Number of hours exercised during the selected month: