Has your medical practitioner ever told you that you have a heart condition or have you ever suffered a stroke? *

Do you ever experience unexplained pains or discomfort in your chest at rest or during physical activity/exercise?*

Do you ever feel faint, dizzy or lose balance during physical activity/exercise? *

Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?*

If you have diabetes (type 1 or 2) have you had trouble controlling your blood sugar (glucose) in the last 3 months?*

Do you have any other conditions that may require special consideration for you to exercise? *

Describe your current physical activity/exercise levels in a typical week *

How often do you currently consume alcohol?*

On average, how many drinks do you consume on days when you drink?*

Have you ever attempted an alcohol-free streak or challenge before?*

What is your current running level?*

What is your 5km PB?

I understand that participation in this program involves physical activity and agree to participate at my own risk.*

I consent to being contacted by the Run Naked team for support and progress check-ins throughout the streak. *