2017 CCFY Student Survey (POST)
DEMOGRAPHIC INFORMATION
NAME: *
Your answer
Date: *
Your answer
1) What Is Your Date of Birth: *
Your answer
2) How old are you?
3) Are you a Boy or a Girl *
Required
4) How do you describe yourself? *
Required
5) How many years have you been in CCFY *
6) What Grade Are You In *
7) At which location do you attend the CCFY Program?
What is your height? (in inches)
Your answer
What is your weight in POUNDS?
Your answer
KNOWLEDGE
Nutrition & Physical Activity
8) How many total servings of fruit and vegetables should you eat each day? *
9) Please Check ALL the healthy drinks that you see below! *
Required
10) Please check ALL the healthy snacks you see below *
Required
11) How many minutes in a day should you exercise or be active *
12) Screen Time: What is the most number of hours you should be in front of a screen (such as TV, computer, cell phone or handheld device) each day? *
CHARACTER KNOWLEDGE
Cross Country For Youth Character Knowledge
13) What are you demonstrating when you complain after losing? *
14) Which of the following DOES NOT show good Leadership *
15) Which is an example of showing high Integrity? *
16) What is the best way to get respect? *
17) What is the best demonstration of COURAGE of those listed below? *
Required
Nutrition & Physical Activity Behavior
Eating & Exercise Habits
18) Yesterday, did you eat ANY fruit? *
19) Yesterday, did you eat ANY vegetables? Vegetables are salads, boiled, baked or mashed potatos and all cooked and uncooked vegetables. (Not French fries) *
20) Please select all of the drinks that you had yesterday. *
Required
21) If you add up how many Waters, 100% Fruit Juices, Skim Milks and Low Fat Chocolate Milks that you had yesterday, how many did you drink?
22) Please check ALL the snacks you had YESTERDAY. *
Required
23) Yesterday, if you add up all the Snacks you ate, check how many of the following you had.
24) If you add up all the OTHER snacks you had yesterday, how many of the following did you eat?
25) Yesterday, after school, did you exercise or do any activities outside or inside your home? *
26) When you think of how much you exercised or played last week, how much time did you spend EACH DAY biking, or running/jogging, or Walking, or playing sports, or dancing or any other physical activities? *
27) Yesterday, did you sit in front of a TV, computer or use a cell phone or handheld device like a tablet? *
28) Yesterday, how many hours did you spend sitting in front of a TV, computer or use a cell phone or handheld device? *
CROSS COUNTRY FOR YOUTH ACTIVITIES
Competition & Participation Habits
29) Cross Country: Have you run a two mile race without stopping? *
30) Did you compete in at least two competitions during the Cross-Country season? *
31) Did you encourage a teammate to not give up in practice or a race this week? *
32) Did you run outside of the Cross-Country for Youth Program at least two times this week? *
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