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Assessment
Please complete the following Exercise Assessment form. You will need to complete a new form for each week you have been tracking. Make sure you enter the weekly dates that your exercises took place.
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* Indicates required question
Record Start Date
*
MM
/
DD
/
YYYY
Record End Date
*
MM
/
DD
/
YYYY
Email
*
Your answer
Name ( First and Last)
*
Your answer
Homeroom Teacher
*
Choose
Fletcher
Morgan
Davidsen
Savage
Wolfe
Lukianchuk
Sullivan
Campbell
Hunter
Price
Novak
Pepper
Coombs
Halford
Stutt
other
Select your Grade level.
*
Choose
Grade 7
Grade 6
Grade 5
Grade 4
Grade 3
Grade 2
Grade 1
Kindergarten
Assessment Questions
Complete each question accurately.
What is your daily exercise point average?
*
Less than 200 points
Between 200 and 300 points
Between 300 and 400 points
Greater than 550 points
Required
How many points did you earn this week?
*
less than 1500
between 1500 and 2100
between 2100 and 3500
greater than 3500
Required
Which exercises are you enjoying the most? You can select up to 4.
*
Yoga
Run hill/stairs
Plank
Bike ride
push ups
hike
jump squats
dance
body break
stretch routine
walk
jump jack
Fitness card activity
Play pass or catch
BodyCoach
Run like Rocky
Chores
Burpees
Required
Which exercises are you enjoying the least? You can select up to 4.
*
Yoga
Run hill/stairs
Plank
Bike ride
push ups
hike
jump squats
dance
body break
stretch routine
walk
jump jack
Fitness card activity
Play pass or catch
BodyCoach
Run like Rocky
Chores
Burpees
Required
If you have an exercise that you would like to see added, briefly describe the exercise in the space below or include a youtube link that shows the exercise and I will evaluate it.
Your answer
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