The code block below illustrates how one might use # and // as comments in your logic and calculations.

# Text can be put here to explain what the logic/calculation does and why.
if ([field1] = '1' and [field2] > 7,

	// This comment can explain what the next line does.
	[score] * [factor],

	// Return '0' if the condition is False.
	0
)

Working...

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

UCHealth Healthy Kids 5210+ Challenge Submission form

Thank you for participating in the UCHealth Healthy Kids 5210+ Challenge!

Please submit one form per participant. Submit your form even if you didn't get enough checkmarks to earn a t-shirt so that you can be counted towards your school participation.

ALL REQUIRED FIELDS MUST BE COMPLETED FOR YOUR FORM TO BE ACCEPTED.

Submit all forms by 9 p.m. Tuesday March 5, 2024.

You do not need to upload or send in your tracking log.

Schools with the highest participation percentage can earn wellness initiative money. Winners will be announced in May.

T-shirts will be delivered to schools by the first week of May 2024.

Questions? Contact your PE teacher or cindy.meland@uchealth.org

Language/Idioma

* must provide value

English

Español

reset

I understand that this form needs to be filled out entirely for my participation to be counted.

* must provide value

Yes

reset

I am completing this form for:

* must provide value

Student

Staff Member

reset

District

* must provide value

Greeley-Evans D6 School District

Poudre School District

St. Vrain Valley School District

Thompson School District

Weld RE-4 School District (Windsor)

Other (Charter School Institute, RE-1, RE-2, RE-5J, RE-7, RE-8, RE-9)

reset

Are you in 6th, 7th or 8th grade?

* must provide value

School

* must provide value

Middle School

* must provide value

School

* must provide value

School

* must provide value

School/Site

* must provide value

School

* must provide value

School name

* must provide value

First Name

* must provide value

Last Name

* must provide value

Role at school/Site

* must provide value

Grade

* must provide value

Middle school grade

* must provide value

Teacher Name (Last name only)

* must provide value

Number of Checked Boxes on Tracking Log

* must provide value

Homeroom Teacher Name (Last name only)

* must provide value

Middle School Total # of checks

* must provide value

T-shirt Size

* must provide value

Did your family complete a blue family log?

Parent Email
If you'd like to opt-in for other Healthy Hearts and Minds program information, e.g. Healthy Kids Run Series or Healthy Kids Connection newsletter, please provide us your email address.

Email
If you'd like to opt-in for other Healthy Hearts and Minds program information, e.g. Healthy Kids Run Series or Healthy Kids Connection newsletter, please provide us your email address.

Do you have any new ideas for prizes or incentives for the 5210+ Challenge? Share your creative suggestions with us!

Notes or additional comments:

Expand

Please verify that ALL required fields are complete. We cannot count your form if it is incomplete.

Verify this email is correct ______

If not please scroll up and edit the email field.

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.