PHYSICAL FITNESS SCORE CARD

SCHOOL NAME
COMPLETE NAME

Last Name

Given Name

TEACHER'S NAME
FIRST QUARTER
PART 1: HEALTH RELATED FITNESS TEST
A. Body Composition: Body Mass Index (BMI)
Height (m)

Weight (kgs)

BMI

Classification

SCHOOL YEAR:
SEX
Middle Name
BIRTHDATE:
AGE
SECOND QUARTE
PART 1: HEALTH RELATED FITNESS TES
A. Body Composition: Body Mass Index
Height (m)

Weight (kgs)

B. Cardiovascular Endurance: 3- Minute Step

Heart Rate per minute
Before the Activity
After the Activity

B. Cardiovascular Endurance: 3- Minute

Heart Rate per min
Before the Activity
Af

C. Strength:
1. Push-up
Number of Push ups

2. Basic Plank
Time

C. Strength:
1. Push-up
Number of Push ups

D. Flexibility:
1. Zipper Test
Overlap / Gap (Cm)
Right
Left

2. Sit and Reach

Score (Cm)
1st
2nd

D. Flexibility:
1. Zipper Test
Overlap / Gap (Cm)
Right
Left

Part 2: SKILL RELATED FITNESS TEST

A. Coordination: Juggling
B. Agility: Hexagon Agility Test
Clockwise:Time (00.00)
Counter-clockwise(00.00)

3rd

Average

2. Sit and R
1st

Part 2: SKILL RELATED FITNESS TEST

A. Coordination: Juggling
B. Agility: Hexagon Agility Test
Clockwise:Time (00.00)
Counter-clockw

C. Speed: 40 Meter Sprint

Time
D. Power: Standing Long Jump
Distance (cm)
First Trial
Second Trial

C. Speed: 40 Meter Sprint

Time
D. Power: Standing Long Jump
Distance (cm)
First Trial
Seco

E. Balance: Stork Balance Stand Test

Right Foot:Time (00.00)
Left Foot : Time (00.00)

E. Balance: Stork Balance Stand Test

Right Foot:Time (00.00)
Left Foo

F. Reaction Time: Stick Drop Test

1st Trial
2nd Trial
3rd Trial

F. Reaction Time: Stick Drop Test

1st Trial
2nd Trial
3rd Trial

4th Trial

THIRD QUARTER
PART 1: HEALTH RELATED FITNESS TEST
A. Body Composition: Body Mass Index (BMI)
Height (m)
Weight (kgs)
BMI
Classification

FOURTH QUARTE
PART 1: HEALTH RELATED FITNESS TES
A. Body Composition: Body Mass Index
Height (m)
Weight (kgs)

B. Cardiovascular Endurance: 3- Minute Step

Heart Rate per minute
Before the Activity
After the Activity

B. Cardiovascular Endurance: 3- Minute

Heart Rate per min
Before the Activity
Af

C. Strength:
1. Push-up
Number of Push ups

2. Basic Plank
Time

C. Strength:
1. Push-up
Number of Push ups

2. Sit and Reach

Score (Cm)
1st
2nd

D. Flexibility:
1. Zipper Test
Overlap / Gap (Cm)
Right
Left

D. Flexibility:
1. Zipper Test
Overlap / Gap (Cm)
Right
Left

Part 2: SKILL RELATED FITNESS TEST

A. Coordination: Juggling
B. Agility: Hexagon Agility Test
Clockwise:Time (00.00)
Counter-clockwise(00.00)

3rd

Average

2. Sit and R
1st

Part 2: SKILL RELATED FITNESS TEST

A. Coordination: Juggling
B. Agility: Hexagon Agility Test
Clockwise:Time (00.00)
Counter-clockw

C. Speed: 40 Meter Sprint

Time
D. Power: Standing Long Jump
Distance (cm)
First Trial
Second Trial

C. Speed: 40 Meter Sprint

Time
D. Power: Standing Long Jump
Distance (cm)
First Trial
Seco

E. Balance: Stork Balance Stand Test

Right Foot:Time (00.00)
Left Foot : Time (00.00)

E. Balance: Stork Balance Stand Test

Right Foot:Time (00.00)
Left Foo

F. Reaction Time: Stick Drop Test

1st Trial
2nd Trial
3rd Trial

F. Reaction Time: Stick Drop Test

1st Trial
2nd Trial
3rd Trial

4th Trial

RD

OL YEAR:
2015-2016
EX
HDATE:
AGE
OND QUARTER
ITNESS TEST
Mass Index (BMI)
BMI

Classification

ce: 3- Minute Step

Rate per minute
After the Activity
2. Basic Plank
Time

2. Sit and Reach

Score (Cm)
1st
2nd

3rd

NESS TEST

Counter-clockwise(00.00)

Average

Time
ump
ance (cm)
Second Trial

Stand Test
Left Foot : Time (00.00)

p Test
3rd Trial

4th Trial

RTH QUARTER
ITNESS TEST
Mass Index (BMI)
BMI

Classification

ce: 3- Minute Step

Rate per minute
After the Activity
2. Basic Plank
Time
2. Sit and Reach
Score (Cm)
1st
2nd

3rd

NESS TEST

Counter-clockwise(00.00)

Time
ump
ance (cm)
Second Trial

Stand Test
Left Foot : Time (00.00)

p Test
3rd Trial

4th Trial

Average

Division of La Union

Caba District

CONSOLIDATED PHYSICAL FITNESS TEST RESULT

School :

Grade Leve

School Y

40 Meter
Sprint

Time

Basic
Plank

Zipper
Test

Sit and
Reach

Juggling

Ave

Hexagon Agility
Test (Time)

Push up

CW

Speed

Score

BMI

Classificatio
n
(N,OW,UW,O
)

Agility

Left (cm)

Height
(kg)

Before the After the

Activity
Activity

Coordinati
on

Right
(cm)

Name of Pupils/Student

Flexibility

Time

Body Composition

Weight(m)

1A
2B
3c

Strength

No. of
Push ups

Nos.

Cardiovascular
Endurance

SKILL

CCW

HEALTH RELATED FITNESS

REL

Prepared by:
AMIE LYN L. SOBREVILLA
TEACHER
June 09,2015
Date Conducted:

Noted by:

Approved:
MERIZA Q. LOZANO
School Head

JOAQUIN A
Public Schools Dis

Grade Level:
RELATED FITNESS

3rd Trial

2nd Trial

Stick Drop Test

1st Trial

Stork Balance
stand Test
(Time)
Left ft.

Standing Long
Jump (cm)

Right ft.

Reaction Time

2nd Trial

Balance

1st Trial

Power

Middle
Score

SKILL

OAQUIN A ABELLERA
Schools District Supervisor