INDIVIDUAL MILEAGE LOG
1. Name: Captain=s Name:
2. Team Name:
Captain=s Phone Number:
$ Record your daily mileage on this Individual Mileage Log.
$ You may also record pounds lost at the end of each week, but this is optional.
$ Call in (phone, fax, mail, or e-mail) your weekly total miles (and pounds lost) to your Team
Captain every Monday. Also report any successes you have had (like feeling better, spending
more time with your family, sleeping better, losing weight, lower blood pressure, clothes
fitting better, watching less TV, etc.).
$ When Walk Across Texas! is over, total all your miles and pounds lost.
$ Turn in this form along with your completed Walk Across Texas! Wrap-Up form to your
Team Captain after the 8th week.
Miles Walked and Pounds Lost
Week 2 Week 3 Week 4 Week 5 Week 6
Week 7 Week 8
(add numbers in
Total pounds lost
Total miles you walked during 8 weeks
(add all weekly total miles in above table)
Total pounds you lost during 8 weeks
(add all weekly pounds lost in above table)
3. How many minutes did you usually walk each time you walked?
Updated January 2010
Educational programs of the Texas AgriLife Extension Service are open to all people without regard to race, color, sex, disability, religion, age, or national origin.
The Texas A&M University System, U.S. Department of Agriculture, and the County Commissioners Courts of Texas Cooperating