Fitness Assessment Record
Printable WorksheetFitness Assessment Record
Personal Fitness Merit Badge — Requirements 4, 5 & 7b
Record your fitness test results at each assessment point to track your progress over the 12-week program.
Physical Fitness Assessments
| Test | Baseline (Pre) | Week 4 | Week 8 | Final (Post) |
|---|---|---|---|---|
| 1-Mile Walk/Run Time (min:sec) | ||||
| Sit-Ups or Plank Count in 60 sec or hold time | ||||
| Push-Ups or Pull-Ups Count in 60 sec | ||||
| Flexibility Sit-and-reach or back scratch |
Assessment Dates
Baseline date
Week 4 date
Week 8 date
Final assessment date
Nutrition Assessment Dates
Record the 3-day food log periods (Req 5c, 7c).
Baseline food log dates
Week 8 food log dates
Week 12 food log dates
Goals & Notes
My fitness goals for this program:
Additional notes or observations:
Counselor Review
Merit Badge Counselor Signature
Date