RetroFit Yourself!

Registration

Please enter the following information to register for the 4-H Bike and Fitness Challenge: RetroFit Yourself. Your responses will be combined with the responses of all other participants so you will not be individually identified on any report prepared. (* indicates a required field)

Username:*
Password:*
Confirm Password:*
Password Hint: If you ever forget your password, this hint will help remind you. Make sure to choose a question that only you can answer.
Question:*	My first pet's name? Mother's maiden name? What is the name of my favorite book?
Answer:*
County of Club Membership:*	Adams Ashland Barron Bayfield Brown Buffalo Burnett Calumet Chippewa Clark Columbia Crawford Dane Dodge Door Douglas Dunn Eau Claire Florence Fond du Lac Forest Grant Green Green Lake Iowa Iron Jackson Jefferson Juneau Kenosha Kewaunee LaCrosse Lafayette Langlade Lincoln Manitowoc Marathon Marinette Marquette Menominee Milwaukee Monroe Oconto Oneida Outagamie Ozaukee Pepin Pierce Polk Portage Price Racine Richland Rock Rusk Sauk Sawyer Shawano Sheboygan St. Croix Taylor Trempealeau Vernon Vilas Walworth Washburn Washington Waukesha Waupaca Waushara Winnebago Wood
Gender:*	Male Female
Race:	American Indian/ Alaskan Native Asian/ Asian American Black/ African American Hawaiian Pacific Islander White Other:
Ethnicity:	Hispanic Non-Hispanic
For youth participants, what grade are you in?
	Elementary (grades K,1,2,3,4,5) Middle School (grades 6,7,8) High School (grades 9,10,11,12,13)
For adult participants, please check the category that best describes you (check all that apply)
	Parent or relative of youth participant Volunteer who works with youth Extension staff Other:
You may enter your email address below to receive an email containing your login information in case you forget it. We will not save your email address, and this will be the only time we email you.
Email Address:

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