As a Mature Fitness Awards USA recipient, you agree to the
use of your name for local and national publicity. Check
if you do not want your name used.
receive your award, send your completed Activity Log and
the Award Registration Form along with $7.95 shipping and
Fitness Awards USA
c/o Mature Market Resource Center
328 West Lincoln Ave., #10
Libertyville, IL 60048-2725
All registrations must be prepaid by check, money order
or credit card.
enclosed for $
($7.95 per registration)
checks payable to: Mature Market Resource Center
Cardholder's Name ___________________________________________