Free Wheelchair Mission | 2021 Virtual Move for Mobility Tracker

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email*

What social media accounts did you post about the Move for Mobility on?*

Please enter the URLs of your posts or your social media names; for example, @fwmission on Instagram, @freewheelchairmission on Facebook. Remember, posting on social media is part of the process to finish and get your medal!

What activity did you do?*

For example: ran a half-marathon, walked a 5K, propelled 10K in a wheelchair, did 50 miles on a stationary bike, hiked a trail, did 1,000 pushups, etc.

Which distance did you complete?*

How long did it take you to complete your Move for Mobility?*

Upload your fitness tracker image (if available)

Max. file size: 300 MB.

Upload your finish line selfie photo*

Accepted file types: jpg, jpeg, png, gif.

Please upload a .jpg or .png file because HEIC files will not go through. Apologies for the inconvenience!