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					                     Virtual Race Across Kansas (Sept 21 - Nov 16)
                          30 minutes of physical activity = 30 miles (total throughout day)
                          30 miles is maximum that can be earned for physical activity per day
                         2 cups or more fruits/vegetables = 30 Miles (total throughout day)
                         30 miles is maximum that can be earned for fruits/vegetables per day
Name:                                     Phone Number:                               Emp ID:
     Week 1                                 21-Sep     22-Sep     23-Sep    24-Sep     25-Sep   Sub Total Week 1 Total
 Physical Activity                                                                                  0
                                                                                                                0
Fruits/Vegetables                                                                                   0
     Week 2           26-Sep     27-Sep     28-Sep     29-Sep     30-Sep    1-Oct       2-Oct   Sub Total Week 2 Total
 Physical Activity                                                                                  0
                                                                                                                0
Fruits/Vegetables                                                                                   0
     Week 3           3-Oct      4-Oct      5-Oct       6-Oct      7-Oct    8-Oct       9-Oct   Sub Total Week 3 Total
 Physical Activity                                                                                  0
                                                                                                                0
Fruits/Vegetables                                                                                   0
     Week 4           10-Oct     11-Oct     12-Oct     13-Oct      14-Oct   15-Oct     16-Oct   Sub Total Week 4 Total
 Physical Activity                                                                                  0
                                                                                                                0
Fruits/Vegetables                                                                                   0
     Week 5           17-Oct     18-Oct     19-Oct     20-Oct      21-Oct   22-Oct     23-Oct   Sub Total Week 5 Total
 Physical Activity                                                                                  0
                                                                                                                0
Fruits/Vegetables                                                                                   0
     Week 6           24-Oct     25-Oct     26-Oct     27-Oct      28-Oct   29-Oct     30-Oct   Sub Total Week 6 Total
 Physical Activity                                                                                  0
                                                                                                                0
Fruits/Vegetables                                                                                   0
     Week 7           31-Oct     1-Nov      2-Nov      3-Nov       4-Nov    5-Nov      6-Nov    Sub Total Week 7 Total
 Physical Activity                                                                                  0
                                                                                                                0
Fruits/Vegetables                                                                                   0
     Week 8           7-Nov      8-Nov      9-Nov      10-Nov     11-Nov    12-Nov     13-Nov   Sub Total Week 8 Total
 Physical Activity                                                                                  0
                                                                                                                0
Fruits/Vegetables                                                                                   0
     Week 9           14-Nov     15-Nov    16-Nov                                               Sub Total Week 9 Total
 Physical Activity                                                                                  0
                                                                                                                0
Fruits/Vegetables                                                                                   0

       Total Program Miles Goal                                               Total Physical Activity Miles     0
            Total Program Miles
     Total Fruit/Vegetable Miles                                               Total Fruit/Vegetable Miles      0
     Total Physical Activity Miles
                                                                                        Total Program Miles     0
                                     0    200   400    600      800 1000
                                                                                Total Program Miles Goal      1000
     * Tracking forms must be submitted to Paul Sandburg by November 17th (via email, fax, or mail)

                 Email                                    Fax                                    Mail
     paul.sandburg@alere.com                          785-291-0524                          Paul Sandburg
                                                                                      Landon State Office Building
                                                                                    900 SW Jackson Street Suite 900
                                                                                          Topeka, KS 66612

                               http://www.khpa.ks.gov/healthquest/virtualrace.html

				
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