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Physical Fitness Form Template

This document is a physical fitness form from the Technological Institute of Philippines' Physical Education Department for the 2022-2023 school year. It collects a student's personal information, pre-test anthropometric measurements like weight and height to calculate BMI, and results from 6 physical fitness tests - step test, sit and reach, pushups, back scratch test, plank test, and wall sit test. The student is asked to record their test results over 2 trials and calculate their averages to assess their physical fitness level.

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Ed Angelo Eise Pacheco
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69 views1 page

Physical Fitness Form Template

This document is a physical fitness form from the Technological Institute of Philippines' Physical Education Department for the 2022-2023 school year. It collects a student's personal information, pre-test anthropometric measurements like weight and height to calculate BMI, and results from 6 physical fitness tests - step test, sit and reach, pushups, back scratch test, plank test, and wall sit test. The student is asked to record their test results over 2 trials and calculate their averages to assess their physical fitness level.

Uploaded by

Ed Angelo Eise Pacheco
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Technological Institute of the Philippines

Quezon City
Physical Education Department
S.Y. 2022-2023
“PHYSICAL FITNESS FORM”

Name: __________________________
Year& Section: __________________ Class schedule: ________________________
Course/subject: __________________ Instructor’s name: ______________________

(Pre-anthropometric)
Weight
(kg): BMI: ____________ Classification: ________________
Below 18.5 Underweight
Height
18.5 – 24.9 Normal/Healthy Weight
(m):
25.0 – 29.9 Overweight
30.0 and Above Obese

Formula: BMI

PICTURE (Anterior view) PICTURE (Lateral view) PICTURE (Posterior view)

POST-PHYSICAL FITNESS TEST


Attach your Google drive link here or
Video Link: If you done it on-cam, write “DONE ON-CAM”
Note: Please check your Google drive link settings, make sure that you properly share it so I can
view on my end.

PHYSICAL FITNESS TEST TRIAL 1 TRIAL 2 AVERAGE RESULTS


= (Trial 1 + Trial 2) ÷ 2
Resting Heart Rate: ________ Rate of Perceived Effort
1. Three (3) minute Step Test Working Heart Rate: _______ (1-10)
Total No. of steps: _________ __________________
2. Sit and Reach
_____inches _____inches _____inches
3. Push-ups (One-minute)
______Repetitions ______Repetitions ______Repetitions
4. ZIPPER TEST/BACK SCRATCH R: R: R:
L: L: L:
5. Plank Test (One-Minute)
______Seconds ______Seconds ______Seconds
6. Wall Sit Test (One-Minute)
______Seconds ______ Seconds ______ Seconds
“I affirm that I have not given or received any unauthorized help on this assignment and that this work is my own”
STUDENT’S SIGNATURE: ____________________________ DATE: _____________________________

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