Fitness Log
Day
Month
September, 2023
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Time Logged
Check if Attended
x
x
6:30 - 8:15
6:30 - 8:15
x
x
6:30 - 8:15
6:30 - 8:15
x
x
6:30 - 8:15
6:30 - 8:15
x
x
6:30 - 8:15
6:30 - 8:15
x
x
6:30 - 8:15
6:30 - 8:15
x
x
6:30 - 8:15
6:30 - 8:15
x
x
6:30 - 8:15
6:30 - 8:15
x
x
6:30 - 8:15
6:30 - 8:15
I attended the gym or fitness classes on the above dates and for the above times.
***You must attend gym/and or fitness classes for 30 minutes or more to qualify for the reimbursement.
___________________
Employee Signature
Peter Wilson
Print name
09/28/2023
___________________
Date