SPORTS SCREENERS CHECKLIST Name _____________________________________
- Name of film/video/TV program:
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TV channel ____________ Time of program ____________ Name of producer __________________________________________
- How would you characterize the film, video or television program?
Circle one: Drama Comedy Thriller/Science Fiction Other If you circled Other, how would you describe it?
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- Did you see any sports or physical activity in the film, video or TV program?
Circle one: YES NO If YES, what sports or physical activities were shown, approximately how many times were they were shown, and who performed the activity (child, adult, male, female, etc)?
What Sports or Physical Activity? How many times? Who did it? ________________________________ _______________ _______________ ________________________________ _______________ _______________ ________________________________ _______________ _______________ ________________________________ _______________ _______________ ________________________________ _______________ _______________ ________________________________ _______________ _______________ ________________________________ _______________ _______________ ________________________________ _______________ _______________ Total number: ______
- Do you think the film, video or tv program encouraged youth to participate in physical activity or sports?
Circle one: YES NO If YES, how?
____________________________________________________________
____________________________________________________________
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- What grade would you give the movie, video or TV program for depicting physical activity or sports participation?
Circle one: A = Excellent B = Good C = Average D = Fair F = Poor