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(Form For Authorized Adult) : RM 9-PA: Sample Sign-Off Form For Completion of OUT-of-Class Physical Activity Practicum

The document is a sign-off form for an authorized adult to verify that a student has completed their out-of-class physical activity practicum and accurately recorded their participation. The form requires the authorized adult's name, signature, date, and relationship to the student. It also has a section for the student's signature and date to certify the accuracy of their recorded physical activity participation.

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Faxman Cavan Singco
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34 views1 page

(Form For Authorized Adult) : RM 9-PA: Sample Sign-Off Form For Completion of OUT-of-Class Physical Activity Practicum

The document is a sign-off form for an authorized adult to verify that a student has completed their out-of-class physical activity practicum and accurately recorded their participation. The form requires the authorized adult's name, signature, date, and relationship to the student. It also has a section for the student's signature and date to certify the accuracy of their recorded physical activity participation.

Uploaded by

Faxman Cavan Singco
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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RM 9–PA: Sample Sign-off Form for Completion of

OUT-of-Class Physical Activity Practicum


(Form for Authorized Adult)

Dear Authorized Adult:

Please review this form and, upon agreement, provide your signature.

I       the authorized adult for      


Name of Authorized Adult Name of Student

do hereby certify and acknowledge the following:


 The above-named student has participated in the physical activities as selected for
his/her OUT-of-class physical activity practicum.
 The above-named student has accurately recorded his/her participation in the selected
physical activities for the OUT-of-class physical activity practicum.

     
Authorized Adult Signature Date

Please indicate your relationship with this student (e.g., parent, aunt, uncle, coach, instructor):

     

Student Sign-off

I      
Name of Student

certify that this record is an accurate account of my physical activity participation in the
OUT-of-class physical activity practicum.

     
Student Signature Date

Date Received      

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