Go4Life is a U. S. Government website for older adults that provides reliable health information, exercises, motivational tips, and free materials to help you fit exercise and physical activity into your daily life



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Create Your Success Story
Go4Life is a U.S. Government website for older adults that provides reliable health information, exercises, motivational tips, and free materials to help you fit exercise and physical activity into your daily life. Staff from the National Institute on Aging (NIA), part of the National Institutes of Health, developed this site.
If you are age 50 years or older and exercise regularly, we invite you to send us your story for the Go4Life website. Please write your own story in your own words. We also would like to post a photo showing you exercising. Tell us:


  • What kind of exercise you do and how often

  • Why you are physically active and how long you’ve been active

  • How exercise and physical activity have helped you

By filling out the following form, you are giving NIA permission to use and disclose the information you submit on the Go4Life website and for any future purposes.


*See Full Disclaimer.

Instructions


Form: Please fill out the form, check the appropriate exercise activities, and write your exercise story (150 words or less). You can e-mail the completed form to Go4Life@nia.nih.gov or print it and mail to:

Go4Life – Exercise Story

National Institute on Aging

Building 31, Room 5C27

31 Center Drive, MSC 2292

Bethesda, MD 20892


Photo: Send us a photo of yourself exercising. We will put the photo with the story on the website. You can send the photo to us by e-mail to Go4Life@nia.nih.gov or mail it with the form. Because of the large number of entries we receive, we cannot return your photo.

Remember





  • You must be 50 years of age or older.




  • The photo! You can mail it with the attached form or send it to us by e-mail to Go4Life@nia.nih.gov




  • We will not send the photo back to you. Please choose one that you can give us permanently. Be sure that the photo you send is one that you own and is not copyrighted by someone else.




  • The personally identifiable information (e.g., full name, phone number) you give us on the form is for our use only in case we need to contact you. It will be maintained in compliance with the Federal Privacy Act (5 USC 552). For additional information on NIA’s privacy policy, please see the following http://www.nia.nih.gov/Policies.htm#privacy.




  • We may not use every story that is sent to us.




  • We may edit the story.




  • We cannot use stories that endorse particular name brands.

Jump to the Share Your Exercise Story Form

Share Your Exercise Story


* See disclaimer below

Date:

Contact information

First Name:



Last Name:

Age:

E-mail Address:

Phone:

State:


Exercise Story


Activities:


 Walking  Jogging  Swimming  Water Aerobics

 Aerobics  Yoga  Dancing  Tennis

 Hiking  Biking  Golf  Weight Lifting

 Other ___________________



Write your exercise story here (150 words or less):




E-mail the completed form and photo to Go4Life@nia.nih.gov or print and mail the form and photo to:

Go4Life – Exercise Story

National Institute on Aging

Building 31, Room 5C27

31 Center Drive, MSC 2292

Bethesda, MD 20892


* Disclaimer



The placement of advertisements or solicitations will not be accepted, and the material you submit, including photographs, must be true to the best of your knowledge, original, and must not have been copied or derived from any material not owned by you. The National Institute on Aging will review the information prior to posting it but will not approve, endorse, or verify the accuracy of the information. You agree to hold the NIA, and others acting on its behalf, harmless for any claims or liability arising out of the Institute’s use of the material. While you retain the rights to the material you submit, you agree further that it may be displayed on the Go4Life website and used by NIA for any future purpose. Because of the volume of submissions, not all stories will be immediately available or available indefinitely. By providing this information, you give your permission to associate your name with your comments.




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