Active Youth Entry Survey

First Name *

Last Name *

Gender *

Date of Birth (Date, Month, Year) *

Postcode *

Ethnicity *

Do you fall into any of the following categories? (mark all that apply) *

Are you ok for your information to be used to study Active Youth? *

Why did you decide to take part in this session? (mark all that apply) *

If I find something difficult, I keep trying until I can do it *

I enjoy taking part in exercise and physical activity *

I feel confident when I take part in exercise and physical activity *

I understand why exercise and physical activity are good for me *

I know how to get involved and improve my skills in lots of different types of exercise and physical activity *

I am able to motivate and influence other people

Selected Value: 1

I feel confident at having a go at things that are new to me

Selected Value: 1

I can do things as well as most other people

Selected Value: 1

How can we help?