10 A
SIUSLAW NEWS ❚ WEDNESDAY, DECEMBER 27, 2017
First Weigh-In Jan. 24 (mandatory!)
th
N
!
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I
S
O
W
L to
It’s BACK...
BE
FLORENCE’S
BIGGEST
WEIGHT PERCENTAGE
LOSER
LOSE-TO-WIN
CONTEST!
Over $1000 in Prizes & Gifts!
FREE ENROLLMENT
14-Week Contest
January 24-May 2, 2018
– Only your weight loss average will be published. –
• Weigh in each week at COASTAL FITNESS & AQUATICS
• Each Wednesday, Jan. 24-May 2, 2018 • 7:30am-9am and 4:30pm-6pm
• Weekly leaders in each category (male & female) will be pictured in the
Saturday edition of the Siuslaw News.
• Learn Healthy Weight Loss Steps
• Look Good - Feel Good
Contest Information Line:
541-997-3441
FREE CONTEST PARTICIPATION • REGISTRATION FORM
Weigh-In Location:
Coastal Fitness &
Aquatics
Please complete and bring or mail this form to the Siuslaw News,
P.O. Box 10, Florence, OR 97439
Registration is FREE. Contestants must
be a minimum of 18 years old or with
parental consent and sign a waiver
form to participate.
Name: _________________________________________
Your registration form must be
received at the Siuslaw News,
by 5pm January 22nd.
148 Maple Street,
Mail: PO Box 10, Florence, OR 97439
Fax: 541-997-7979
or via our website
www.thesiuslawnews.com
______________________________________________
Address: _______________________________________
Phone: _________________________________________
Email: _________________________________________
Are you a subscriber of the Siuslaw News?
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NO
OFFICE USE ONLY
Face Photo #__________ Full Portrait Photo # _________ Disclaimer Signed
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Sponsored by
Siuslaw News
148 Maple St., Florence
541-997-3441
2285 Hwy. 101, Florence
541-997-8086