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* 1. Name:

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* 2. What school do you attend?

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* 3. How old are you?

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* 4. What grade are you in?

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* 5. Why did you join Velocity? Check all that apply.

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* 6. What was your favorite activity?

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* 7. What was your favorite discussion? Why?

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* 8. Do you think you will participate in Velocity next year?

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* 9. What would you change about Velocity?

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* 10. Physical activity is important to me.

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* 11. Physical activity is the best part of my day.

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* 12. I would change my schedule to participate in physical activity.

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* 13. Life is better because I am physically active.

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* 14. Physical activity feels good.

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* 15. I look forward to physical activity.

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* 16. I do not enjoy physical activity.

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* 17. I don't like thinking about physical activity.

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* 18. When I miss a day being physically active, I like it.

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* 19. Physical activity is hard work.

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* 20. I wish there were better ways to get healthy other than being physically active.

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* 21. I have to force myself to be physically active.

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* 22. When you can choose, how often do you change what you eat because of how much fat or sugar it has?

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* 23. How confident do you feel about picking healthy meals?

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* 24. Pick a hot lunch that you think is the healthiest.

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* 25. Now, pick the hot lunch that you would actually eat more than once.

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* 26. When you can choose, how often do you exercise or play outside?

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* 27. On the weekend, how many hours a day do you spend in front of a TV, computer or video game?

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* 28. When you are not in school and have a choice, how much of your time do you spend inside (playing video games, reading, watching TV, etc.) and how much do you spend outside (playing tag, playing sports, shooting basketball, etc.)?

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* 29. I have an adult I can talk to about problems that I'm facing.

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* 30. I can do most things I try.

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* 31. I enjoy trying new things.

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* 32. I can work with someone who has different opinions than mine.

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* 33. There are many things I do well.

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* 34. I enjoy working together with other students.

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* 35. I stand up for myself without putting other people down.

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* 36. I try to understand how other people feel and think.

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* 37. I often question the decisions I make.

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* 38. On the whole, I am satisfied with myself.

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* 39. At times, I think I am no good at all.

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* 40. I feel I have a number of good qualities

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* 41. I am able to do things as well as most other people.

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* 42. I feel I do not have much to be proud of.

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* 43. I certainly feel useless at times.

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* 44. I feel that I am a person of worth.

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* 45. I wish I could have more respect for myself.

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* 46. I have a positive attitude about myself.

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