Happy Information Request

Rotary Sponsored Program

Supported by:

Information Request

If you would like to join the "Happy" program, would like to become a sponsor or simply need more information please complete the form below.

Name:

Phone:

Address:

City/State/Zip:

Email:

I'm interested in:

More Information

Joining the Program

Starting a Team *

* Please note only Rotary Members may be team leaders. However, you do not need to be a Rotary member to participate in the program.

To Join - Complete this section.

We will contact you regarding your participation.

No Team Preference Please add me to the following team.

Team Leader/Team Name:

Age:

Male Female

Health History:

Please indicate your weekly personal goal:

Other:

15 points per week is considered a successful goal.

Registraion Fee: There is a "one time" registration fee of $10, to cover initial entry of information and establishing a "member" web page. There is no additional cost. Please mail your check to: Happy Program, PO Box 547, Jackson, MI 49204, USA.

Requested
User Name:

Password:

As with any physical exercise program, if you have any questions, we suggest you clear them with your doctor before starting the program.

Disclaimer:
I hereby acknowledge that I will not hold the "Happy" program, or Rotary International, liable for any accident or other claim due to the program.

Signature: