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PHYSICAL FITNESS RECORD

NAME SECTION BIRTHDAY AGE GENDER

Blueberry 10/01/2007 13 Male

Health Related Fitness Test


A. BODY COMPOSITION (Body Mass Index)

Height Weight BMI Classification


(m) (kg)

1.50 42.95 19.1 normal

B. CARDIOVASCULAR ENDURANCE: 1. Push Up

Number of Push Ups Interpretation

10

2. Basic Plank

Time Interpretation

20

C. FLEXIBILITY: 1. Zipper Test

Overlap/Gap (Centimeters) Passed/Failed

Right Left Best Score Interpretation

10 10 20

2. Sit and Reach

1st 2nd Best Score Interpretation

10 10 20

Skill Related Fitness Test


A. BALANCE: Stork Balance Test

Right Foot (Time) Left Foot Interpretation


(Time)

10 10 20

B. REACTION: Stick Drop Test

1st 2nd 3rd Middle Interpretatio


Score n

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