University of Southeastern Philippines

PHYSICAL EDUCATION PROGRAM

FITNESS ASSESSMENT RECORD

NAME: RAYHANY S. MACARIMBAN AGE: 18 GENDER: FEMALE

BIRTHDATE: 05/23/2005 INSTRUCTOR’S NAME: JOHN GASBAN

P.E SCHEDULE: Every Thursday @01:00-03:00pm SECTION: 1D2 AREA: PECC Gym
PRE-TEST DATE: 10/24/2023 POST-TEST DATE: _________________
RESTING HEART RATE: 80

A. Solve Using Karvonen Formula

https://www.topendsports.com/fitness/karvonen-formula-calculator.htm
MAXIMUM HEART RATE: 220-AGE = 202
Target Level 1 (60%) _______
Target Level 2 (70%) _______
Target Level 3 (80%) _______

B. BODY MASS INDEX (BMI): https://www.bcbst.com/providers/MPMTools/BMICalculator.shtm

WEIGHT in KG: 62 HEIGHT in METERS: 1.55448
BMI Result: 25.8 – Overweight __

C. Fitness Goal:
Lose weight/ Fat ____
Gain Weight /Muscle ___
Lose Fat and Gain Muscle ___

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 PE 111 – Movement Enhancement

I. HEALTH RELATED FITNESS

CARDIOVASCULAR PRE-TEST REMARK POST- REMARKS DIFFERENCE
ENDURANCE SCORE S TEST
SCORE
Month of
October Month of
2023 November
2023
Home Step Test 138 bpm bpm

FLEXIBILITY
Modified Sit and 55 meters
Reach Test
Static Flexibility Test 40cm
–Trunk and Neck
STRENGTH
Sargeant Jump Test

Sit Ups Test-

Press up Test

II. SKILL-RELATED PRE-TEST REMARK POST- REMARKS DIFFERENCE

FITNESS SCORE S TEST
SCORE
Month of
October Month of
2023 November
2023
AGILITY
‘T’ Drill Test 16.13
seconds

POWER and SPEED

30m Acceleration
Test
REACTION TIME
Ruler Drop Test 10 cm

BALANCE
Standing Stork Test Left= 5.37
seconds
Right=8.75
seconds
COORDINATION
Hand and Eye 12
Coordination
Test

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 PE 111 – Movement Enhancement

INTERPRETATION:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
____________________________________________________.

Instructors Signature: ________________________________

Date: ________________________________________

Learning Evidence/Output to Assess: LE1 Individual Fitness Test Performance (PRE-TEST)

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 PE 111 – Movement Enhancement

This task requires you to execute individual performance of the different introduced selected and
applicable fitness tests on agility, balance, body composition, cardiovascular endurance, coordination, flexibility,
muscular endurance, muscular strength, power, reaction time and speed. Individual pacing is considered since
every student has different ability of coping during skills performance.

Above
Area to At Standard
Below Standard Standard
Assess/Criteria 3 pts
2 pts 4 pts
Observes Below Standard At Standard Above Standard
boundaries
Student rarely sticks to Student usually sticks to
boundaries such as personal boundaries such as personal Student always sticks to
space and the workout area. space and the workout area. boundaries such as personal
space and the workout area.

Participates Below Standard At Standard Above Standard

safely
Student has to be reminded 3 Student has to be reminded 2
times to participate safely times to participate safely when Student participates safely when
when performing the test. performing the test performing the test.

Appropriate Below Standard At Standard Above Standard

equipment use
Student occasionally Student usually demonstrates
demonstrates inappropriate appropriate use of equipment Student always demonstrates
use of equipment appropriate use of equipment.

Responds to Below Standard At Standard Above Standard

signals
Sometimes responds
inappropriately to a whistle
and/or commands when
participating in physical fitness
test.
Usually responds in a timely
manner to a whistle and
commands when participating in
physical fitness test.
Always promptly responds to a
whistle and commands when
participating in physical fitness
test

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