Name: Short Term Goal Long Term Goal
DATE
TYPEOF ACTIVITY or ACTIVITIES
TOTAL MINUTES OF ACTIVITY
INTENSITY DATE (1,2,or3 basedon chart below)
TYPEOF ACTIVITY or ACTIVITIES
TOTAL MINUTESOF ACTIVITY
INTENSITY (1,2,or3 basedon chart below)
Types of Activities (write the # in the columns)
1. Team Sports: baseball/softball, basketball, football, water polo, soccer, cheerleading, rowing 2. Individual Sports: golf, wrestling, swimming, martial arts, weight training, gymnastics 3. Fitness Activities: running, walking, dancing, yoga/pilates, biking, tennis, skateboarding, aerobics 4. PE class: I am currently enrolled in AHS PE class 5. Other: Please fully explain in Activity Column if you have participated in other activities
Intensity Levels
Level 1: Low exertion, little or no perspiration. Little
increase in heart rate/breathing Ex: walking to bus
Level 2: Able to speak without gasping for air,
beginning of light perspiration
Level 3: Sweating profusely and breathing heavily