The purpose of this study was to gain insight into variation in opportunities for middle-school aged adolescents in rural North Carolina to be physically active in extra-curricular school environments.  It also examined school personnel’s perceptions about the key institutional and community systems that influence policy and resource decisions for leisure time physical activity (LTPA) programming, as well as the function of extracurricular sport and LTPA programming in school environments.  The results of this study documented the available opportunities as well as the inclusive or exclusionary characteristics of programs that have the potential to get adolescents more active both in the school and community. Moreover, these results may demonstrate that schools and communities with large socially and economically disadvantaged populations, particularly in rural areas, have fewer opportunities for important structured LTPA.