iWW Attendee Questionnaire


Thank you for registering for our upcoming iWarriorWalk Pathfinder Retreat.

In order to assist us in maximizing your experience while at the retreat,

please consider filling out and submitting the questionnaire found below.

If you prefer to not answer any of the questions, please feel free to leave them blank.

All information will be kept confidential.

Thank you

Guest Information
  1. Salutation:
  2. Marital Status
Emergency Contact Information
General Questions About You
  1. Are you employed?
  2. Do you volunteer?
  3. Do you have lots of stress in your life?
  4. Have you suffered any personal loss in your life?
  5. Do you smoke?
  6. If yes, would you like to quit or reduce the amount you smoke?
  7. Do you drink?
  8. If yes, would you like to quit or reduce the amount you drink?
  9. Do you drink coffee or have other caffeine sources?
  10. If yes, would you like to quit or reduce your caffeine intake?
  11. Do you currently have a walking program?
  12. If yes, how often do you walk?
  13. If no, are you willing (and able) to participate in our leisurely and OPTIONAL morning walks?
  14. How long do you walk on average?
  15. Do you currently have an exercise program?
  16. If yes, how often do you exercise?
  17. How long do you exercise on average?
Other
Submit Your Questionnaire
  1. Captcha
 

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