Take-Home Physical Activity Kits - Student Form
Thank you for using your Jeffco Physical Activity Kit. We hope you had fun, exercised and learned new ways to move.

Please answer the following questions HONESTLY. Anyone who completes the form, is eligible to win a prize.
First and Last Name *
Your School Email *
Your School *
Your Grade *
How many minutes did you exercise using the physical activity kit during the ENTIRE WEEK? *
Using the kit, what was the greatest number of minutes you exercised for during any ONE DAY this week? *
How many minutes of exercise did you get through additional activities (i.e. running, sports team, biking, etc.) during the entire week? *
Please rate how you enjoyed the equipment *
It was good
It was OK
I did NOT like it
Did not try
Flying Disc
Jump Rope
Resistance Band/ Fitness Exercises
Reaction or Tennis Ball
Would you want to use the take home physical activity kit again? *
What could make the take home kit better? *
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