Gender: Male
Female
Age category: 10-15
16-20
21-30
31-40
41-50
51-60
61-70
71-...
1. Which of the following do you do? (Circle)
a. Running
b. Hiking
c. Walking
d. Biking
e. Watching TV
f. Aerobics
g. Weight
2. Which one do you do most often?
a. Running
b. Hiking
c. Walking
d. Biking
e. Watching TV
f. Aerobics
g. Weight
3. Do you do any other sport?
a. Yes
circle: tennis, volleyball, soccer, football, wrestling, baseball, basketball, other ___________
b. No
4. Other than hiking, how often do you do your sports?
a. less than once a month
b. once a month
c. twice a month
d. once a week
e. twice a week
f. more than twice a week
5. Do you like hiking?
a. Yes
b. No
6. How often do you hike?
a. less than once a month
b. once a month
c. twice a month
d. once a week
e. twice a week
f. more than twice a week
7. How far do you usually hike?
a. less than a mile
b. 1 mile
c. 2 miles
d. 3 miles
e. more than 3 miles
8. Do you use special equipment?
a. Yes
circle: shoes, poles, hats, clothes, other ____________
b. No
9. What kind of terrain do you choose most often?
a. easy
b. medium
c. hard
10. Why do you hike?
a. it keeps me fit
b. for fun
c. because of nature
d. lose weight
e. other: _____________
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