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[SURVEY PREVIEW MODE] Physical Activity

1/27/2017

Survey

Physical Activity Survey

1.

What grade are you in?

10

11

12

2.

What is your gender?


Female
Male

3.

How important is daily physical activity to you?


Extremely important
Very important
Moderately important

Notvery important
Not important

4.

at all

How often do you engage in physical activity, not

including phys

ed class?

Never

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[SURVEY PREVIEW MODE] Physical Activity

1/27/2017

4.

Survey

How often do you engage in physical activity, not

including phys

ed class?

Never

Once or twice

week

Three or four times

week

Almostyevery d

any physical activity outside of school?

If so,

what do you do?

6. Do

you play any school sports or participate in any after-

school activities? Please check all that apply.


Junior high basketball
Junior high volleyball
Senior high basketball

Senior high volleyball


Cross country ski club

Archery club
Curling club

do not participate

in any

Other (please specify)

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[SURVEY PREVIEW MODE] Physical Activity

1/27/2017

7. If

Survey

you do not participate in any extra-curricular activities,

please give your reasons why.

(I

want your honest opinion,

the more reasons the better)

8.

What would make you more likely to join

sports team or

after-school club? Are there certain sports or activities that


you would like to see offered?

9.

Would you be interested in joining

lunch intramural

program?
Yes

10. If you are

interested in

lunch intramural program, what

sports would you like to see offered?

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