INDIVIDUAL SELF ASSESSMENT 
DATE: _______________ 
1. FLEXIBILITY: 
Sit and Reach Score:_____Inches   Norm percentile =_____% 
2. DYNAMIC STRENGTH: 
No. Sit ups:____   Norm percentile =_____% 
3. DYNAMIC STRENGTH: 
No. Push ups:____   Norm percentile =_____% 
4. CARDIOVASCULAR: 
1.5 Mile Run Score:_____Min. _____Sec.   Norm percentile =_____% 
1 Mile Walk Score:_____Min. _____Sec.   Rating =___________ 
NOTES: 






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