1	I would like my museum or garden to be an early adopter of the Let's Move Museums and Gardens inititative

2	Institution Name

3	Contact for future messages about Let's Move Museums and Gardens Name: Email Address: Phone Number:

4	Association membership is not required to participate in the planned initiative. However, please indicate the Association(s) of which you are a member (check all that apply): American Association of Museums Association of Children's Museums American Public Gardens Association