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Name: ______Period: ____ Date: ______
My Personal Fitness Contract
I, ______, am going to make a commitment to helping build my lifelong fitness and nutrition habits that will assist me in sustaining a long, actively-healthy lifestyle. I will do my best to follow all of the guidelines I have designed in my fitness plan. My fitness plan will identify areas where I, ______need improvements in both fitness and nutrition. I will design realistic, achievable, and measureable goals. My activities will be ones that I can consistently incorporate into my current lifestyle. I will keep fitness logs so that I can see if I am achieving the guidelines of my fitness plan as well as seeing my improvements in my overall fitness.
I understand the conditions of my fitness plan and will do my best to incorporate this plan into my daily life.
______
Student (Print First and Last Name)
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Student SignatureDate
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Parent SignatureDate
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Teacher’s SignatureDate
Rubric Score: ______
Personal Fitness Questionnaire
Helping to identify strengths and weaknesses
1. How would you rate your overall activity level?
0 / 1 / 2 / 3 / 4Sedentary / Slightly Active / Somewhat Active / Regularly Active / Extremely Active
2. How would you rate your overall fitness?
0 / 1 / 2 / 3 / 4Not Fit At All / Slightly Fit / Somewhat Fit / Fit / Extremely Fit
3. Do you exercise regularly?
0 / 1 / 2 / 3 / 4Never/No Interest / I want to start
Have tried starting / Used to and starting back / Been exercising regularly this year / I have always exercised regularly and will continue
4. How would you rate your experience with exercise?
0 / 1 / 2 / 3 / 4Know nothing about exercise / Beginner-
Know a little / Intermediate-
have some confidence / Learning- really learning a lot / Advanced- know how to do all exercises well
5. Rate how your environment at home: encourages fitness as an important part of YOUR lifE?
0 / 1 / 2 / 3 / 4Not at all / A little / It is talked about / We try to be active / Excellent
6. How would you rate your current cardioRESPiATORY fitness leveL?
0 / 1 / 2 / 3 / 4Terrible / Fair / Average / Good / Excellent
7. How would you rate your current muscular strength level?
0 / 1 / 2 / 3 / 4No Strength / Not Very Strong / Moderately Strong / Strong / Very Strong
8. How would you rate your current muscularendurance level?
0 / 1 / 2 / 3 / 4No Strength / Not Very Strong / Moderately Strong / Strong / Very Strong
9. How Flexible are you?
0 / 1 / 2 / 3 / 4None / A little / Some muscles / Most muscles
in body / All muscles (U & L Extremity) are extremely flexible
10. HOW OFTEN DO YOU EXERCISE PER WEEK OUTSIDE OF PE CLASS?
0 / 1 / 2 / 3 / 4I do not exercise / 1 day/week / 2 days/week / 3 days/week / 4 or more days/week
11. HOW OFTEN DO YOUR PARENTS EXERCISE PER WEEK?
0 / 1 / 2 / 3 / 4They do not exercise / 1 day/week / 2 days/week / 3 days/week / 4 or more days/week
12. HOW WOULD YOU RATE YOUR EATING HABITS?
0 / 1 / 2 / 3 / 4I do not pay attention to what I eat. / I sometimes am aware of what I am eating. / I will often substitute a food with a better choice / I avoid high sugar foods and am aware of what I am eating / I rarely make bad food choices. My parents help support my good habits.
13. HOW OFTEN DO YOU READ FOOD LABELS?
0 / 1 / 2 / 3 / 4I never read them. / Once a day / Twice a day / Once every meal / Each time I eat foods that I am not familiar with.
14. DO YOU KNOW HOW MANY CALORIES YOU ARE SUPPOSED TO EAT?
0 / 1No idea / Yes, I do
15. HOW WOULD YOU RATE YOUR OVERALL NUTRITION (FOOD CHOICE AND CALORIE INTAKE)
0 / 1 / 2 / 3 / 4Terrible / Fair / Average / Good / Excellent
16.DO YOU KNOW WHAT THE FIVE FOOD GROUPS ARE?
0 / 1 / 2 / 3 / 4No idea / I can name 1 of them / I can name 2 of them / I can name 3 of them / I know all of them
TOTAL POINTS HERE: ______
0-16 = sedentary, not making the best lifestyle choices
17-30 = slightly active, could make better lifestyle choices
31-45 = often makes good choices, but is not always consistent
46-61 = makes good choices, living a healthy lifestyle
Rubric Score: ______
Personal Fitness Plan Pre-Assessment
Name: ______Period: __1__ Date: ______
INSTRUCTIONS: Please answer the following by using your Assessment Cards. Please put quality thought and effort into each of your answers. You will need to review the following charts to complete this section:
-Fitnessgram Standards for the Healthy Fitness Zone Chart
-Fitnessgram PACER Conversion Chart
Part A – Fitness Component Evaluation
Write your scores and circle yes or no to indicate if you are in the Healthy Fitness Zone (HFZ). Flexibility is either pass or fail.
TEST / Question / Your Score / ARE YOU IN THE ZONE?PACER / What is your 20-meter PACER score? / YES / NO
BMI (height/weight) / What is your BMI? / YES / NO
Curl Ups / How many curls ups did you do / YES / NO
Trunk Lift / What is your measurement in inches? / YES / NO
Push-Ups / How many push-ups can you do? / YES / NO
Sit and Reach / Did you pass your “Sit and Reach” / PASS / FAIL
Part B – Fitnessgram Pass/Fail Evaluation
- In reviewing the test results in Part A, give yourself (1) point for each “yes” response and (0) points for each“no” response. How many total points did you earn for Part A? ______
- How many of the 6 Fitnessgram assessments were you in the HFZ? ______
*You have to pass 5 of the 6 Fitnessgram assessments to pass the test.
Part C – Fitness Evaluation
Circle the Fitness Component(s) that you need to improve on the most and the ones you need to improve on the least.
IMPROVE on the MOST (Weaknesses)IMPROVE on the LEAST (Strengths)
a. Body Composition a. Body Composition
b. Flexibility b. Flexibility
c. Trunk Lift c. Trunk Lift
d. Muscular Strength d. Muscular Strength
e. Muscular Endurance e. Muscular Endurance
f. Aerobic Capacity f. Aerobic Capacity
Rubric Score ______
Fitness Goal Planning Sheet
Name: ______Period: 1 Date: ______
What are your fitness goals? Mark all that apply.
__ Improve Cardiorespiratory Endurance __Reduce Body Fat for BMI
__General Health__ Improve Flexibility in Hamstrings
__ Improve Muscular Definition __ Improve Muscular Strength
__ Improve Muscular Endurance __Sports Performance__Reduce Stress
__Lose Weight__Medical Reasons __Self-Esteem/Confidence
(I don’t know is not an answer)
Other______
Questions that will help you toward setting goals.
1. Where will you perform most of your fitness activities? (Circle your answers)
Home Inside /Outside Fitness Facility (gym, health club, pool, etc.) Physical Education Class
2. What time of day can you do most of your exercise? (Circle your answer)
Any timeMorning (6AM-11:59AM)Afternoon (12PM-5:59PM)Evening (6PM-9PM)
- What equipment do you have available on a regular basis including School?
(Circle all that apply)
NothingFree Weights (dumbbells, etc.)Weight machinesBroom Stick
Treadmill or other cardio home machines Hula Hoops/HoopsConesChairs/Bench
Resistance Bands Exercise VideosJump RopesBicycle, Skateboards, Roller Blades
Med BallsTowelsStability BallMat
Other (explain) ______
4. Which of the following are your personal obstacles in adopting a regular fitness program? (Circle all that apply)
- Intimidated and embarrassed when I exercise e. I get bored pretty easily when I exercise
- I can’t really find the time to exercise f. I have to exercise alone
- I get frustrated because I don’t see results right away g. Family obligations
- My exercise setting does not meet my needs. h. I do not have personal obstacles; I am lazy
5. If you wanted to find out more about how to live a healthier lifestyle, what two types of people do you think you could talk to?
a)b)
6. What sports or fitness activities do you enjoy participating in and why?
7. What type of fitness activities/sports do your parents/guardians participate in?
Rubric Score ______
SET YOUR GOALS
Write your SMART goals, Specific, Measureable, Achievable, Realistic and Timely. Write on a separate sheet of paper if you need more space. Use the page 7 to help or go to
- Write your cardiorespiratory endurance goal here: (PACER)
______
2. Write your muscular strength goal here: (PUSH-UPS)
______
3. Write your muscular endurance goal here: (CURL-UPS)
______
4. Write your flexibility goal here: (SIT AND REACH/TRUNK LIFT)
______
5. Write your body composition goal here: (BMI)
______
Rubric Score ______
SELECT ACTIVITIES
Now that you have your goals written down. It is time to select activities. Choose activities that develop all 5 health related components, select activities that you will support and commit to doing during the dates you don’t have PE.Write down 4 exercises in each box below. See sample exercise page (class handout), select exercises and cool-down stretches that you can do and commit to do. Use this link to understand types of stretches We will do dynamic warm up in class, pay attention to their names and what they stretch.
Muscular strength-
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Cardiorespiratory Endurance
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Dynamic stretches
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- / Cool-Down
Static Stretching
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Rubric Score ______
Applying the Principles of Training
Extra Credit for 7th grade
SEE Glossary of Terms to COmPlETE
CARDIORESPIRATORY ENDURNACE (CR)
ACTIVITY EXPANSION
Choose ONE activity (exercise) from the cardiorespiratory category on your Activity Sheet
Write a CARDIORESPIRATORY SHORT TERM GOAL (1-3 months): ______
Write a CARDIORESPIRATORY LONG TERM GOAL (4-6 months): ______
Proper Name of the CARDIO ACTIVITY: ______
Week 1 F.I.T.T
Frequency = ______days/week How often (days/week) are you going to do this activity?
Intensity = _____-____Beats per minute (BPM) How hard? What Heart Rate (HR) range will your workout be in?
Time = ______min How long?
Type=______type of activity that you chose to perform to meet a specific goal
PROGRESSION- WEEK 2 NEEDS TO BE MORE CHALLENGING THAN WEEK 1 BY ADJUSTING ANY COMBINATION OF THE FREQUENCY, INTENSITY,TYPE OR TIME.
Week 2 F.I.T.T
Frequency = ______days/week How often (days/week) are you going to do this activity?
Intensity = _____-____BPM How hard? What Heart Rate (HR) range will your workout be in?
Time = ______min How long?
Type=______type of activity that you chose to perform to meet a specific goal
MUSCULAR STRENGTH (MS)
ACTIVITY EXPANSION
Choose ONE activity (exercise)from the cardiorespiratory category on your Activity Sheet
Write a MS SHORT TERM GOAL (1-3 months):
______
Write a MS LONG TERM GOAL (4-6 months): ______
Proper Name of the CARDIO ACTIVITY: ______
Week 1 F.I.T.
Frequency = ____days/week How often (days/week) are you going to do this activity?
Intensity = _____Rated Perceived Exertion (RPE)How hard? What is the RPE (1-10 Scale) for this exercise? See your fitness/activity log for RPE
Sets = ____ Repetitions: ____ Weight:______
Time = ____min How long?
Type=______type of activity that you chose to perform to meet a specific goal
PROGRESSION- WEEK 2 NEEDS TO BE MORE CHALLENGING THAN WEEK 1 BY ADJUSTING ANY COMBINATION OF THE FREQUENCY, INTENSITY,TYPE OR TIME.
Week 2 F.I.T.
Frequency = ____days/week How often (days/week) are you going to do this activity?
Intensity = _____Rated Perceived Exertion (RPE)How hard? What is the RPE (1-10 Scale) for this exercise? See your fitness/activity log for RPE
Sets = ____ Repetitions: ____ Weight:______
Time = ____min How long?
Type=______type of activity that you chose to perform to meet a specific goal
MUSCULAR ENDURANCE (ME)
ACTIVITY EXPANSION
Choose ONE activity (exercise)from the cardiorespiratory category on your Activity Sheet
Write a ME SHORT TERM GOAL (1-3 months): ______
Write a ME LONG TERM GOAL (4-6 months): ______
Proper Name of the CARDIO ACTIVITY: ______
Week 1 F.I.T.
Frequency = ____days/week How often (days/week) are you going to do this activity?
Intensity = _____Rated Perceived Exertion (RPE)How hard? What is the RPE (1-10 Scale) for this exercise? See your fitness/activity log for RPE
Sets = ____ Repetitions: ____ Weight:______
Time = ____min How long?
Type=______type of activity that you chose to perform to meet a specific goal
PROGRESSION- WEEK 2 NEEDS TO BE MORE CHALLENGING THAN WEEK 1 BY ADJUSTING ANY COMBINATION OF THE FREQUENCY, INTENSITY,TYPE OR TIME.
Week 2 F.I.T.
Frequency = ____days/week How often (days/week) are you going to do this activity?
Intensity = _____Rated Perceived Exertion (RPE)How hard? What is the RPE (1-10 Scale) for this exercise? See your fitness/activity log for RPE
Sets = ____ Repetitions: ____ Weight:______
Time = ____min How long?
Type=______type of activity that you chose to perform to meet a specific goal
FLEXIBILITY (FLEX)
ACTIVITY EXPANSION
Choose ONE activity (exercise)from the Flexibility category on your Fitness Plan Brainstorming Sheet.
Write a FLEX SHORT TERM GOAL (1-3 months): ______
Write a FLEX LONG TERM GOAL (4-6 months): ______
Proper Name of the CARDIO ACTIVITY: ______
Week 1 F.I.T.
Frequency = ____days/week How often (days/week) are you going to do this activity?
Intensity = _____
Time = ____ seconds per stretch______sets
Type=______type of activity that you chose to perform to meet a specific goal
PROGRESSION- WEEK 2 NEEDS TO BE MORE CHALLENGING THAN WEEK 1 BY ADJUSTING ANY COMBINATION OF THE FREQUENCY, INTENSITY, TYPE OR TIME.
Week 2 F.I.T.
Frequency = ____days/week How often (days/week) are you going to do this activity?
Intensity = _____
Time = ____ seconds per stretch______sets
Type=______type of activity that you chose to perform to meet a specific goal
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