Staying Alive in 2005 Official Start Form
Take this form with you when you get weighed in at the Mall of America, Gold’s Gym, or by a physician or a nurse. Fill in all the fields. Keep this form until you get further direction from the show or on drphil.com. This is your OFFICIAL entry form, and you will need it in order to bump someone out of the Challenge.
Challenger’s Name: ___________________________________________________
Percentage of Body Fat or BMI Index (if available): ____________
Goal Weight: ____________
Official’s Signature and Printed Name: ____________________________________
Official’s Title: ______________________________________________________
Phone Number: _________________________________