Professional Documents
Culture Documents
PE1 Week 6 Module
PE1 Week 6 Module
Activities
Chapter 4 SELF-TESTING ACTIVITY
Intended Learning Outcomes: At the end of this chapter, the students are expected to:
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PERSONAL DATA
The following information is required and will assess your physical fitness level to
establish a customized exercise program. Your health questionnaire and test results are
confidential and will not be released to anyone other than yourself.
1. In the past year, how often have you been engaged in physical activity?
_____ 4-5 times a week _____ 1-2 times a week
_____ 2-3 times a week _____ None
2. What type of physical activity do you consider fun?
________________________________________________________________________
____________________________________________________________________
3. What are your personal barriers to exercise?
________________________________________________________________________
____________________________________________________________________
4. What physical activity have you been successful with in the past?
________________________________________________________________________
____________________________________________________________________
12. Specifically describe what you would like to accomplish through your fitness program during
the next:
1 month,
_______________________________________________________________________________
_____________________________________________________________
4 moths,
_______________________________________________________________________________
_____________________________________________________________
1 year,
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_______________________________________________________________________________
_____________________________________________________________
13. Do you have negative feelings toward, or have you had any bad experiences with physical
activity programs?
____ YES ____ NO
If yes, explain.
_______________________________________________________________________________
_____________________________________________________________
_______________________________________________________________________________
_____________________________________________________________
14. Do you start an exercise program but then find yourself unable to stick with them?
____ YES ____ NO
15. How much are you willing to devote to an exercise program?
____ minutes/day ____ days/week
16. Are you currently involved in regular exercise?
____ YES ____ NO
17. Can you exercise during the work day?
____ YES ____ NO
18. Would an exercise program interfere with your job?
____ YES ____ NO
19. Would it benefit your job?
____ YES ____ NO
20. What type of exercise interest you?
____ Walking ____ Jogging ____ Swimming ____ Cycling
____ Strength Training ____ Rowing ____ Tennis ____ Golf
____ Stretching ____ Others (please specify, ___________________________)
21. What do you want exercise to do for you?
_______________________________________________________________________________
_____________________________________________________________
22. Use the following scale to rate each goal separately:
Very Important Not Important
1 2 3 4 5 6 7 8 9 10
23. How much would you like to change your current weight?
(+) _____ lbs. (-)_____lbs
24. Anything else you would like your trainer/instructor to know?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
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________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
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Signature over Printed Name of Student
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Movement
Basic movement skills are very important to an individual, if the students have
properly learned the basic skills they are confident and competent enough to develop
complex movement skills that will allow them to enjoy any sports and physical activity
without hesitation. They will surely move with ease and free from injuries.
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