The Active Lifestyle Activity Log Sheet

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The Active Lifestyle Activity Log
Participant Name _________________________________________________________ Date Started __________________________________________
Group ID ___________________________________________________ Age ________ Date Completed _________________________________________
# of Minutes or
# of Minutes or
Day
Physical Activities
Day
Physical Activities
Pedometer Steps
Pedometer Steps
Mon
 
 
Mon
 
 
Tues
 
 
Tues
 
 
Wed
 
 
Wed
 
 
Thurs
 
 
Thurs
 
 
Fri
 
 
Fri
 
 
Sat
 
 
Sat
 
 
Sun
 
 
Sun
 
 
Healthy Eating
Healthy Eating
—Select a goal for this week
—Circle and continue with last week’s goal, and add a new goal
Participant Signature
Date
Participant Signature
Date
# of Minutes or
# of Minutes or
Day
Physical Activities
Day
Physical Activities
Pedometer Steps
Pedometer Steps
Mon
 
 
Mon
 
 
Tues
 
 
Tues
 
 
Wed
 
 
Wed
 
 
Thurs
 
 
Thurs
 
 
Fri
 
 
Fri
 
 
Sat
 
 
Sat
 
 
Sun
 
 
Sun
 
 
Healthy Eating
Healthy Eating
—Circle and continue with previous goals, and add a new goal
—Circle and continue with previous goals, and add a new goal
Participant Signature
Date
Participant Signature
Date
# of Minutes or
# of Minutes or
Day
Physical Activities
Day
Physical Activities
Pedometer Steps
Pedometer Steps
Mon
 
 
Mon
 
 
Tues
 
 
Tues
 
 
Wed
 
 
Wed
 
 
Thurs
 
 
Thurs
 
 
Fri
 
 
Fri
 
 
Sat
 
 
Sat
 
 
Sun
 
 
Sun
 
 
Healthy Eating
Healthy Eating
—Circle and continue with previous goals, and add a new goal
—Circle and continue with previous goals, and add a new goal
Participant Signature
Date
Participant Signature
Date
Key to Healthy Eating
Verification
I made half my plate fruits and vegetables
I certify that I met the requirements of the Presidential Active Lifestyle Award.
At least half of the grains that I ate were whole grains
I was physically active for at least 5 days each week and I met my healthy eating goals.
I chose fat-free or low fat (1%) milk, yogurt, or cheese
I have performed my healthy eating and physical activities for at least 6 weeks.
I drank water instead of sugary drinks
Participant Signature _____________________________________________________________
I chose lean sources of protein
Supervising Adult’s Signature (if applicable) ____________________________________________
I compared sodium in foods like soup and frozen meals and chose
Note: Submit this paper log to your teacher or group administrator, or keep for your own records. Please
foods with less sodium
do not submit to the President’s Challenge office. See inside back cover for award ordering information.
I ate seafood
I ate smaller portions
The Active Lifestyle Activity Log
Participant Name _________________________________________________________ Date Started __________________________________________
Group ID ___________________________________________________ Age ________ Date Completed _________________________________________
# of Minutes or
# of Minutes or
Day
Physical Activities
Day
Physical Activities
Pedometer Steps
Pedometer Steps
Mon
 
 
Mon
 
 
Tues
 
 
Tues
 
 
Wed
 
 
Wed
 
 
Thurs
 
 
Thurs
 
 
Fri
 
 
Fri
 
 
Sat
 
 
Sat
 
 
Sun
 
 
Sun
 
 
Healthy Eating
Healthy Eating
—Select a goal for this week
—Circle and continue with last week’s goal, and add a new goal
Participant Signature
Date
Participant Signature
Date
# of Minutes or
# of Minutes or
Day
Physical Activities
Day
Physical Activities
Pedometer Steps
Pedometer Steps
Mon
 
 
Mon
 
 
Tues
 
 
Tues
 
 
Wed
 
 
Wed
 
 
Thurs
 
 
Thurs
 
 
Fri
 
 
Fri
 
 
Sat
 
 
Sat
 
 
Sun
 
 
Sun
 
 
Healthy Eating
Healthy Eating
—Circle and continue with previous goals, and add a new goal
—Circle and continue with previous goals, and add a new goal
Participant Signature
Date
Participant Signature
Date
# of Minutes or
# of Minutes or
Day
Physical Activities
Day
Physical Activities
Pedometer Steps
Pedometer Steps
Mon
 
 
Mon
 
 
Tues
 
 
Tues
 
 
Wed
 
 
Wed
 
 
Thurs
 
 
Thurs
 
 
Fri
 
 
Fri
 
 
Sat
 
 
Sat
 
 
Sun
 
 
Sun
 
 
Healthy Eating
Healthy Eating
—Circle and continue with previous goals, and add a new goal
—Circle and continue with previous goals, and add a new goal
Participant Signature
Date
Participant Signature
Date
Key to Healthy Eating
Verification
I made half my plate fruits and vegetables
I certify that I met the requirements of the Presidential Active Lifestyle Award.
At least half of the grains that I ate were whole grains
I was physically active for at least 5 days each week and I met my healthy eating goals.
I chose fat-free or low fat (1%) milk, yogurt, or cheese
I have performed my healthy eating and physical activities for at least 6 weeks.
I drank water instead of sugary drinks
Participant Signature _____________________________________________________________
I chose lean sources of protein
Supervising Adult’s Signature (if applicable) ____________________________________________
I compared sodium in foods like soup and frozen meals and chose
Note: Submit this paper log to your teacher or group administrator, or keep for your own records. Please
foods with less sodium
do not submit to the President’s Challenge office. See inside back cover for award ordering information.
I ate seafood
I ate smaller portions

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