Activity Survey

You will be participating in three activity periods in the next few months as part of a special program. Please indicate your interest level in the following activities so that we can put together a program that you will enjoy!

 

Wii Fit

  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 

X-Box Kinect

  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 
Musical interest - guitar
  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 
Musical interest - singing
  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 
Dance
  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 
Sign Language
  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 
Healthy Snack Club
  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 
Walking Club
  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 
Zumba
  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 
Yoga
  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 
Strength Training PS
  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 
Vegetarian Cooking
  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 
Knitting/crocheting
  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 
Paracord Bracelet Making
  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 
Science Club
  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 
Art Club
  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 
Music Club
  • 1- Very Low Interest
  • 2- Low Interest
  • 3- Moderate Interest
  • 4- High Interest
  • 5- Very High Interest
 

Please add any ideas you may have but did not see on the list.

 

 

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