We Activate Bismarck Mandan : iActivate

iActivate

iActivate
Please complete the following information to pledge your commitment to get active. We will be drawing one winner each month to receive a prize.

* Date- example 08/08/2005

* Name

* User Name

* Address

* Date of Birth

* Height

* Weight

Bismarck Public Schools Fitnessgram results for walk test(if you've participated in this). In minutes...

Bismarck Public Schools Fitnessgram results for Abdominal Curl Up (if you participated in this.)

Bismarck Public Schools Fitnessgram results for Flex Arm Hang (if you participated in this). In seconds...

Bismarck Public Schools Fitnessgram results for Sit and Reach (if you participated in this). In inches...

* In general would you say your health is?

* Number of hours of media time each day (Television, Video Games and Computer/Internet)

* How many servings of fruit do you usually eat per day?

* How many servings of vegetables do you usually eat per day?

* How many glasses of water or juice do you usually drink per day?

* How many glasses or cans of pop or soda do you usually drink per day?

* The Surgeon General recommends regular physical activity on most if not all days of the week.
Regular physical activity means at least 30 minutes (adults) or 60 minutes (children) of moderate physical activity most days of the week.
Examples include: walking, running, moderate to vigorous playing, yardwork, sports.

* On how many of the past 7 days did you participate in physical activity for at least 30-60 minutes?

* Which of these statements best describes your view?

* When you are getting your regular physical activity, how would you describe your exertion or effort?

* I will be active this many times per week.

* My other activate goal is...

We agree to dedicate special family time this many time(s) per week.

Our family time will be on...

Our reason for making these commitments are:

* I commit to improving my health and fitness or my family's health and fitness by becoming more active, eating better and getting regular physical activity on most in not all days of the week. We agree to support each other and help each other eat better and become more active.
I Agree
I Disagree