VWP Enrollment Check List: FITNESS & MEASUREMENT TRACKER
CELEBRATE HEALTH – Virtual Wellness Program
VIRTUAL FITNESS & MEASUREMENT TRACKER
Participant Name: ___________________________ Program/Class #: ___________________________
Assessment Dates:
- Test 1 (Onset): ___________
- Test 2 (Midpoint): ___________
- Test 3 (Final): ___________
Fitness Assessment (Strength, Endurance, Cardio, Balance)
| Test Item | Test 1 | Date | Test 2 | Date | Test 3 | Date |
|---|---|---|---|---|---|---|
| Sit-Ups (1 min) | ______ | ____ | ______ | ____ | ______ | ____ |
| Push-Ups (1 min) | ______ | ____ | ______ | ____ | ______ | ____ |
| Squats (1 min) | ______ | ____ | ______ | ____ | ______ | ____ |
| Pull-Ups (Men) / Dead Hang (Women) | ______ | ____ | ______ | ____ | ______ | ____ |
| 200m Run (time) OR Jumping Jacks (count in 1 min) | ______ | ____ | ______ | ____ | ______ | ____ |
| Balance Test (seconds single-leg) | ______ | ____ | ______ | ____ | ______ | ____ |
Physical Measurements
| Measurement | Test 1 | Date | Test 2 | Date | Test 3 | Date |
|---|---|---|---|---|---|---|
| Weight (lbs/kg) | ______ | ____ | ______ | ____ | ______ | ____ |
| Waist (in/cm) | ______ | ____ | ______ | ____ | ______ | ____ |
| Chest (in/cm) | ______ | ____ | ______ | ____ | ______ | ____ |
| Arm (in/cm) | ______ | ____ | ______ | ____ | ______ | ____ |
| Thigh (in/cm) | ______ | ____ | ______ | ____ | ______ | ____ |
Weekly Weigh-In Tracker (Weeks 1–12)
| Week | Date | Weight (lbs/kg) | Notes / Observations |
|---|---|---|---|
| 1 | ____ | ____ | ____ |
| 2 | ____ | ____ | ____ |
| 3 | ____ | ____ | ____ |
| 4 | ____ | ____ | ____ |
| 5 | ____ | ____ | ____ |
| 6 | ____ | ____ | ____ |
| 7 | ____ | ____ | ____ |
| 8 | ____ | ____ | ____ |
| 9 | ____ | ____ | ____ |
| 10 | ____ | ____ | ____ |
| 11 | ____ | ____ | ____ |
| 12 | ____ | ____ | ____ |
Notes / Observations:
