3 Day Physical Activity Recall Survey

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* 1. Name

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* 2. Age

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* 3. Grade

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* 4. School

The following pictures represent the 3DPAR Activities Scale.

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The numbers below represent the activities in which you participated in each 30-minute block of time during the 3 days you are recalling. You may use this as a guide as you complete the next three questions.

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* 6. If you used # 59 "Other" as an answer for any of your DAY #1 activities, list those activities here. Please be brief, using just a few words or less.

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* 8. If you used # 59 "Other" as an answer for any of your DAY #2 activities, list those activities here. Please be brief, using just a few words or less.

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* 10. If you used # 59 "Other" as an answer for any of your DAY #3 activities, list those activities here. Please be brief, using just a few words or less.

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