Registration for Glen Burnie Seventh-day Adventist Church
InStep for Life Program

  As announced in church, we are now registering members and others for the organized InStep exercise program You may go to http://www.instepforlife.com for more information. Also, if you have any questions email or call us at (443) 867-6658.

Our church is very interested in the physical and spiritual well-being of its members as well as our friends in the community. Please fill in the form below, double-check to make sure you fill in all blanks, and click on the submit button. Or, you may print this form, fill in all blanks, and mail ot to the address below.

Glen Burnie Seventh-day Adventist Church
Attn: InStep for Life Program
508 Aquahart Road
Glen Burnie, Maryland 21061

Release: Submission of this form indicates that I will follow the recommendations for assuring a safe physical activity program. I understand that it is my responsibility to use caution and prudence in my walking/fitness program to insure my own safety. I participate willingly and release the church and all other associated organizations from any liability regarding my safety or any harm that may come from my participation in this program.

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Full Name
Street Address
City
State
Zip Code
What is your date of birth? (Day/Month/Year)
Your e-mail address:
Your Phone Number:

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