UNIVERSITY CUP ENTRY FORM

UNIVERSITY CUP ENTRY FORM

The “Be Well” University Cup is a university-wide wellness challenge. Points are earned between March 1, 2023, through April 25, 2023, for each person that participates in various University sponsored events. Teams can be made up of three to five people. (5 people max)

The team with the most participation will be awarded the title of “Be Well” University Cup Champions at the annual Islander Awards Celebration.

First time users of Free Fridays, Islander Strolls, Walk for Wellness, or Wellness Punch Pass must enroll at the Recreational Sports Office at the Dugan Wellness Center.

The University Cup Entry Form is used to capture participation by individual employee participating in the Be Well University Cup. Team points will be added by the Wellness Committee board who review the entries. Points will be posted on a leader board on the Be Well University Cup website at the end of each week.

Date of Event*

One Entry allowed Per EVENT!

UIN*

Name*

Email Address*

Is a Team being formed for an event?

Yes

Team Name

Team Leader

CLIMB Name of Session*

Name of Session is required for CLIMB Events.

I-Socials/Mental Wellness Name of Session*

Name of Session is required for I-Socials/Mental Wellness Event.

Lunch & Learn Type Event*

BCBSTX Event

Airrosti Event

File Upload*

Please upload pictures of your walks or the number of steps from your smartwatch or pedometer here.

Drag and drop files here or

Job Title*

Employing Department*

Select

Supervisor Email Address*

Employee Acknowledgement

I have visited my physician for an annual health examination within the past year.*

Injuries that may result during participation will not be treated as work-related injuries.*

By submitting this application, you certify and understand the statements included are correct.*

Send me a copy of my responses

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