Student Daily Physical Activity Log (Monthly)
Student Daily Physical Activity Log (Monthly)
Student Daily Physical Activity Log (Monthly)
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Name ______________________<br />
Week of:<br />
Day<br />
Monday<br />
Tuesday<br />
Wednesday<br />
Thursday<br />
Friday<br />
Saturday<br />
Sunday<br />
Parent/Guardian Signature:<br />
<strong>Activity</strong><br />
RM 7–PA: <strong>Physical</strong> <strong>Activity</strong> <strong>Log</strong><br />
Grade ____<br />
<strong>Student</strong>'s <strong>Daily</strong> <strong>Physical</strong> <strong>Activity</strong> <strong>Log</strong> for the Month of _____________________________________<br />
Primary Health-<br />
Related Fitness<br />
Exercise Time Health Habit Satisfaction<br />
<strong>Daily</strong> Reflection / Rating<br />
Component Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
0 0 0 Total 0 0 0<br />
Total Hours for the Week 1 0.0 0.0 Total Hours of Moderate to Vigorous <strong>Activity</strong> for the Week<br />
<strong>Student</strong> Signature: ______________________________________ I hereby certify that this record is an accurate account of my physical activity participation.
Name ______________________<br />
Week of:<br />
Day<br />
Monday<br />
Tuesday<br />
Wednesday<br />
Thursday<br />
Friday<br />
Saturday<br />
Sunday<br />
Parent/Guardian Signature:<br />
<strong>Activity</strong><br />
RM 7–PA: <strong>Physical</strong> <strong>Activity</strong> <strong>Log</strong><br />
Grade ____<br />
<strong>Student</strong>'s <strong>Daily</strong> <strong>Physical</strong> <strong>Activity</strong> <strong>Log</strong> for the Month of _____________________________________<br />
Primary Health-<br />
Related Fitness<br />
Exercise Time Health Habit Satisfaction<br />
<strong>Daily</strong> Reflection / Rating<br />
Component Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
0 0 0 Total 0 0 0<br />
Total Hours for the Week 2 0.0 0.0 Total Hours of Moderate to Vigorous <strong>Activity</strong> for the Week<br />
<strong>Student</strong> Signature: ______________________________________ I hereby certify that this record is an accurate account of my physical activity participation.
Name ______________________<br />
RM 7–PA: <strong>Physical</strong> <strong>Activity</strong> <strong>Log</strong><br />
Grade ____<br />
Week of:<br />
<strong>Student</strong>'s <strong>Daily</strong> <strong>Physical</strong> <strong>Activity</strong> <strong>Log</strong> for the Month of _____________________________________<br />
Day<br />
Primary Health-<br />
<strong>Activity</strong><br />
Related Fitness<br />
Exercise Time Health Habit Satisfaction<br />
<strong>Daily</strong> Reflection / Rating<br />
Component Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Monday<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Tuesday<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Wednesday<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Thursday<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Friday<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Saturday<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Sunday<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
0 0 0 Total 0 0 0<br />
Parent/Guardian Signature: Total Hours for the Week 3 0.0 0.0 Total Hours of Moderate to Vigorous <strong>Activity</strong> for the Week<br />
<strong>Student</strong> Signature: ______________________________________ I hereby certify that this record is an accurate account of my physical activity participation.
Name ______________________<br />
Week of:<br />
Day<br />
Monday<br />
Tuesday<br />
Wednesday<br />
Thursday<br />
Friday<br />
Saturday<br />
Sunday<br />
Parent/Guardian Signature:<br />
<strong>Activity</strong><br />
RM 7–PA: <strong>Physical</strong> <strong>Activity</strong> <strong>Log</strong><br />
Grade ____<br />
<strong>Student</strong>'s <strong>Daily</strong> <strong>Physical</strong> <strong>Activity</strong> <strong>Log</strong> for the Month of _____________________________________<br />
Primary Health-<br />
Related Fitness<br />
Exercise Time Health Habit Satisfaction<br />
<strong>Daily</strong> Reflection / Rating<br />
Component Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
0 0 0 Total 0 0 0<br />
Total Hours for the Week 4 0.0 0.0 Total Hours of Moderate to Vigorous <strong>Activity</strong> for the Week<br />
<strong>Student</strong> Signature: ______________________________________ I hereby certify that this record is an accurate account of my physical activity participation.
Name ______________________<br />
Week of:<br />
Day<br />
Monday<br />
Tuesday<br />
Wednesday<br />
Thursday<br />
Friday<br />
Saturday<br />
Sunday<br />
Parent/Guardian Signature:<br />
<strong>Activity</strong><br />
RM 7–PA: <strong>Physical</strong> <strong>Activity</strong> <strong>Log</strong><br />
Grade ____<br />
<strong>Student</strong>'s <strong>Daily</strong> <strong>Physical</strong> <strong>Activity</strong> <strong>Log</strong> for the Month of _____________________________________<br />
Primary Health-<br />
Related Fitness<br />
Exercise Intensity Health Habit Satisfaction<br />
<strong>Daily</strong> Reflection / Rating<br />
Component Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
Light Mod Vig Habit High Med Low<br />
Exercise<br />
Diet<br />
Stress<br />
Sleep Overall Rating: /5<br />
0 0 0 Total 0 0 0<br />
Total Hours for the Week 5 0.0 0.0 Total Hours of Moderate to Vigorous <strong>Activity</strong> for the Week<br />
0.0 Total Hours for the Month of<br />
0.0 Total Hours of Moderate to Vigorous <strong>Activity</strong> for the Month<br />
<strong>Student</strong> Signature: ______________________________________ I hereby certify that this record is an accurate account of my physical activity participation.
Name ______________________<br />
RM 7–PA: <strong>Physical</strong> <strong>Activity</strong> <strong>Log</strong><br />
1 Exercise 0 0 0<br />
Diet 0 0 0<br />
Stress 0 0 0<br />
Sleep 0 0 0<br />
2 Exercise 0 0 0<br />
Diet 0 0 0<br />
Stress 0 0 0<br />
Sleep 0 0 0<br />
3 Exercise 0 0 0<br />
Diet 0 0 0<br />
Stress 0 0 0<br />
Sleep 0 0 0<br />
4 Exercise 0 0 0<br />
Diet 0 0 0<br />
Stress 0 0 0<br />
Sleep 0 0 0<br />
5 Exercise 0 0 0<br />
Diet 0 0 0<br />
Stress 0 0 0<br />
Sleep 0 0 0<br />
T Exercise 0 0 0<br />
Diet 0 0 0<br />
Stress 0 0 0<br />
Sleep 0 0 0<br />
Grade ____
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