DE LA SALLE LIPA

Integrated School
Health and Wellness Program for Students
My Physical Fitness Activity Log

Name of Student: Section:

BMI Category based on pre-assessment
Underweight Normal
Overweight/Obese
BMI Category based on mid-assessment
Underweight Normal Overweight/Obese

REMARKS REASON/S FOR NOT ACCOMPLISHING THE

Week TASKS A - accomplished TASKS
No./Date PA - partially
accomplished
NA - not accomplished

Week 1 Warm up
Date: Main Task
Cool
Down
Week 2 Warm up
Date: Main Task
Cool
Down
Week 3 Warm up
Date: Main Task
Cool
Down
Week 4 Warm up
Date: Main Task
Cool
Down
Week 5 Warm up
Date: Main Task
Cool
Down

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Parent’s/Guardian Signature
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SAL LE
LIPA
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