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  2. 2016
  3. October
  4. Y
  5. Youth Survey
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Questions marked with a * are required Exit Survey
 
Contact Information
* First Name : 
* Last Name : 
 
 
 
* Date of Birth
   
 
 
 
* Male or Female
 
 
 
* School Attending
   
 
 
 
* How Physically Active are you
 
5-7 days per week
 
3-5 days per week
 
1-3 days per week
 
<1 day per week
 
 
 
* Do you exercise or play a sport at least 30 minutes 3 or more times per week
 
Yes
 
No
 
 
 
* Do you warm up pre-workout, cool down post-workout and stretch pre and post workout
 
yes
 
no
 
 
 
* In general are you pleased with the condition of your body
Extremely Unsatisfied
Unsatisfied
Neutral
Satisfied
Extremely Satisfied
 
 
It is Important to me that I...
* eat lots of vegetables
* eat lots of fruits
* eat lots of carbohydrates
* eat lots of protein
* drink lots of water
 
 
 
* I eat fast food
 
Daily
 
2-3 times per Week
 
1 time per Week