9:10 – 11:10 PM

Tuesday 5
PE SCHEDULE PE NO.
PERSONAL FITNESS PLAN

NAME: BUNCIO, JOSHUA M. DATE: FROM MARCH ____ TO JUNE ____

FITNESS GOAL: GAIN WEIGHT

Dietary Goal: EAT MORE CARBOHYDRATES

Lifestyle Change: (optional) EAT 3 TIMES A DAY WITH 2 SERVING RICE

PHYSICAL ACTIVITY FREQUENCY INTENSITY TYPE TIME Set

How often do I How hard do I What specific physical activity do I perform? How long do I perform How many times are
perform the physical perform the physical the physical activity? going to perform the
activity? activity? activity?
Warm up and
Stretching
(head to foot) 5x a week Moderate Active 5 Minutes 1 Set
rest/StretchingJum
ping Jacks

Workout proper

3x a week Moderate Jogging 20 Minutes 2 Sets

Workout proper

3x a week Moderate Jump Rope 10 Minutes 5 Sets

Workout proper

2x a week Moderate Burpees 5 Minutes 1 Set

Workout proper

2x a week Moderate Squat Jumps 5 Minutes 6 Repetition,

3 Sets

Workout proper

2x a week Moderate Triceps Dips 5 Minutes 2 Sets

Cool down
(head to foot) Cool
5x a week Moderate down/Stretching 5 Minutes 1 Set

Remarks:
 RUBRIC ON
Personal Fitness Plan (20 points)

20 points 15 points 10 points 5 points 0 points

Complete Insufficient Insufficient Insufficient None
information was information was information information was submission
provided (41 items) provided by the was provided provided by the
- Basic information student. Lacks 1 by the student. student. Lacks
(PE schedule, PE to 10 out of 41 Lacks 11 to 20 21 to 30 out of
number, Name, required out of 41 41 required
Date) information required information
- Fitness goal
information
- Dietary goal
- 7 Frequency
- 7 Intensity
- 7 Types of
activities
- 7 Time
- 7 Set

RUBRIC ON
PERSONAL GOAL ACHIEVEMENT
30 points

Excellent Very Good Good Fair Poor

30 25 20 15 10 0
Level of Achieved Achieved Accomplished Maintained No set goals Non
Achievement beyond what what is below what is current participation
is expected expected expected fitness status