Free CHILDREN'S ACTIVITY CHART, DPH 40071 - Wisconsin


File Size: 19.8 kB
Pages: 1
Date: November 19, 2004
File Format: PDF
State: Wisconsin
Category: Health Care
Author: DHFS/DPH/BCHP
Word Count: 88 Words, 532 Characters
Page Size: 792 x 612 pts (letter)
URL

http://dhs.wisconsin.gov/forms/DPH/dph40071.pdf

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DEPARTMENT OF HEALTH AND FAMILY SERVICES Division of Public Health DPH 40071 (10/04)

STATE OF WISCONSIN

CHILDREN'S PHYSICAL ACTIVITY CHART

Name ______________________________________ Start F I N I S H

Month ______________________

3 4 5 6

2

1

31

30 29 28 27 26

7 8 9 10 11 12 13

Fill or color in a segment for each hour of physical activity. Try to get an hour of activity each day so you can keep "pace" with the days of the month. Any active type of play or sport activity counts.

25

24 23 22 21 20 14 15 16 17 18 19