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* 1. Type your FIRST NAME

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* 2. Type your LAST NAME:

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* 3. SCHOOL

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* 4. GRADE:

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The purpose of this questionnaire is to remember and record the amount of physical activity that you performed for the past 3 days. Fill in the schedule of activities you did from Sunday, Monday, and Tuesday.

1. For each half hour time period, choose from the first column drop down menu which activity best describes what you did for each half hour.

2. Then rate how physically hard each activity was. After looking at the pictures below, choose the intensity level (Light, Moderate, Hard, or Very Hard) in the second column to decide the intensity for each half hour activity.

The purpose of this questionnaire is to remember and record the amount of physical activity that you performed for the past 3 days.  Fill in the schedule of activities you did from Sunday, Monday, and Tuesday.<br><br>1. For each half hour time period, choose from the first column drop down menu which activity best describes what you did for each half hour. <br> <br>2. Then rate how physically hard each activity was. After looking at the pictures below, choose the intensity level (Light, Moderate, Hard, or Very Hard) in the second column to decide the intensity for each half hour activity.

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Below are the activities you will be selecting from:

Below are the activities you will be selecting from:

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