Republika ng Pilipinas

Republic of the Philippines

Kagawaran ng Edukasyon
Department of Education
REHIYON V (BIKOL)
REGION V (BICOL)
TANGGAPANG PANSANGAY NG MGA PAARALAN NG LUNGSOD IRIGA
SCHOOL DIVISION OFFICE OF IRIGA CITY
MATAAS NA PAARALAN NG STA. MARIA
STA. MARIA HIGH SCHOOL

PHYSICAL FITNESSS TEST SCORE SHEET

Name: John Rhio N. De La Cruz Age: 12 Birthday: May 30, 2010 Sex: Male
Grade & Section: 7 Love
PART I: HEALTH-RELATED FITNESS TEST
A. BODY COMPOSITION: Body Mass Index (BMI)
Height (cm) Weight (kg) BMI Classification

B. CARDIOVASCULAR FITNESS: 3 Minute Step Test

Heart Rate per Minute
Before the Activity After the Activity

C. MUSCULAR STRENGTH AND ENDURANCE

90 Degree Push-ups Basic Plank

D. FLEXIBILITY
Zipper Test Sit and Reach
Overlap/Gap (cm.) Score (cm.)
Right Left 1st Try nd
2 Try 3rd Try

PART II: HEALTH-RELATED FITNESS TEST

A. COORDINATION: Paper Juggling Score:
B. AGILITY: Hexagonal Agility Test
Clockwise: time (00:00) Counterclockwise: time (00:00) Average time

C. SPPED: 40 Meter Speed Time:

D. POWER: Standing Long Jump
Distance (centimeter)
First Trial Second Trial

E. BALANCE: Stork Balance Stand Test

Right Foot Time (00:00) Left Foot Time (00:00)

F. REACTION TIME: Stick Drop Test

1st Trial 2nd Trial 3rd Trial Middle Score

JOHN RHIO N. DE LA CRUZ ROXANNE MARIE Q. MARGATE

Student’s printed name over signature MAPEH Teacher
Sta. Maria High School
Cawayan, Sta. Maria, Iriga City
School ID Number: 302250
Email: 302250@r5-2.deped.gov.ph