Weigh to Go Facebook Contest Rules and Submission Forms
Thank you for your interest in our Valley Weight Loss Clinic Weigh to Go Facebook Contest. We look forward to seeing all of the success stories! Please find contest details below.
Submissions will be accepted from June 1 through September 1st, 2014. All submissions will be posted to the Valley Weight Loss Clinic Facebook page the first week of September. Contestants are encouraged to invite friends and family to like and share their pictures until November 30th 2014. The individual with the most likes/shares will win a Fitbit and a lifetime discount of 30% in our meal replacement products.
To enter, email the following to contactus@www.valleyweightlossclinic.com:
- Completed Entry Form
- Before and After picture
- Signed media release/consent form
- A few paragraphs about your weight loss journey
Hard copies will also be accepted by our clinic staff. (Hard copies including photos will not be returned).
If you would like your story submitted to Optifast or Medifast for consideration in their weight loss success promotions, please indicate this on the release/consent form. The Valley Weight Loss Clinic staff will submit the information on your behalf. For consideration in these promotions your weight loss story should include:
- What was your motivation to lose weight?
- How did being overweight impact your social/work life?
- Why did you choose Optifast/Medifast?
- Have you tried other diets?
- When did you first see results?
- How have others responded to your weight loss?
- What health improvements have you experienced?
- Has your life changed after losing weight.
To learn more about the Optifast or Medifast weight loss promotions please visit their sites.
Optifast Promotion: https://www.optifast.com/Pages/inspiration.aspx
Medifast Promotion: http://www.medifastmedia.com/med/pages/submit-your-success/index.htm
Weigh to Go Facebook Contest Official Entry Form
Name: ________________________________________________________
Address: ________________________________________________________
Phone: ________________________________________________________
Email : ________________________________________________________
If you would like us to submit your information to Optifast or Medifast please complete the following additional items.
Please submit my information to: Optifast Medifast
Occupation: ___________________________________________________________
Starting weight: _____________ Current weight: _________ Height _____________
Married: Yes No
Children: Yes No
Have you reached your goal: Yes No
Gender: Male Female
Weight Loss Start Date: ______________ Weight Loss End Date: _____________
Did you have any of the following medical issues prior to your weight loss?
None High Blood Pressure High Cholesterol
Heart Disease Acid Reflux/GERD Gout
Diabetes Type 1 Sleep Apnea Celiac Disease
Diabetes Type 2 Depression Other
VALLEY WEIGHT LOSS CLINIC
Weight To Go Contest
Media Release/Consent Form
I _______________, hereby give my consent to Valley Weight Loss Clinic and its affiliates, permission to use my name, portrait or picture, my story, and my voice for advertising and editorial purposes. Such consent is granted freely and without obligation.
I understand that the above uses may include, but are not limited to newsletters, brochures, websites including Facebook, Twitter and www.valleyweightlossclinic.com, posters, or any other type of promotional advertising.
I authorize that “my story” may be submitted to (check box below) weight loss competition online for a chance to win with their company as well.
Medifast Optifast None
_________________________ _________________________
Full Name (Print) Signature
_________________________ _________________________
Phone Number Date
_________________________________________________________________________
Address
_________________________________________________________________________
Email Address