09-10 Physical Education Syllabus      

N E U Q U A V A L L E Y H I G H S C H O O L

*** Safety is a primary concern. When using equipment and working with others you must adhere to safety factors and procedures related to each activity.  You must REPORT ALL INJURIES to your teacher.

 

*** Please keep valuables at home! Theft does occur. The best prevention is to keep all valuables out of the locker room. The next best prevention is to keep items locked at all times! While we do have locker room supervision by our staff during passing periods, we can not be responsible for students’ personal items.

 

*** Locker rooms/Gymnasium/Weight Room/PE Hallway: No food, gum, or beverages. All school rules apply concerning the use of cell phones and cameras. Consequences will follow the student handbook.

 

***Locks will be assigned to each student.  Students are strongly encouraged not to share locks and/or lockers!  Locks will be turned in at the end of the school year.  If you fail to turn in your lock you will be charged a $5 replacement fee.

 

Assessment

In our physical education program, we assess students’ cognitive and psychomotor performance, while continually working to enhance the affective domain as well. While physical education may require times of subjective analysis of student performance, we will use objective data to assess when at all possible. Each day will be worth 10 points possible, all of which the student must earn. Students will be held to high standards and challenged each and every day. All students are required by the state of Illinois to pass 8 semesters of Physical, Health, and Safety Education in order to graduate.

 

Grading Scale: Physical Education Grade:

100-90 A Demonstrates outstanding progress

89-80 B Demonstrates above average progress

79-70 C Demonstrates average progress

69-60 D Demonstrates minimum acceptable progress

59-0 F Demonstrates unacceptable progress

 

Participation: Participation is made of total points in the unit grade. This grade will be based on a 10 point daily rubric system. Grades may be determined both objectively and subjectively. Use of heart rate monitors, pedometers and other technological devices may assist in determining this grade. In addition, student behavior and dress may also affect this grade. Students will be warned in the following matter concerning his/her participation during warm-ups, stretching, activity time, and/ or cool-down time:

Strike 1: 8/10 (-2points)

Strike 2: 6/10 (-4 points)

Strike 3: 4/10 (-6 points) and student will be removed from activity and asked to walk the remainder of the hour to earn 4 points. If behavior becomes a problem and/or student refuses to walk 0/10 points will be given for the day and student will be removed to the office.

Jr/Sr PE Classes: Failure to go to fitness center the correct number of days per week will result in -8 points per day missed.

-          Ex. If you are expected to go to the fitness center 3 days in one week, yet you only go 1 day your overall points for the week will be reduced by 16 points (-8 for each day missed).

 

Dress: All students need to wear appropriate Physical Education attire: shorts, athletic pants, t-shirts, or sweat-shirts, and athletic shoes. Clothing must be a maroon, grey, or white in color only. Shirts may be plain or carry an MCHS logo and they must cover the torso and undergarments even when active. Jewelry should be removed before entering the gym and a tardy may be assigned if you are sent back to remove it.

A “No Dress” day (student forgets shoes or uniform, doesn’t want to rent, or just doesn’t want to dress) will result in the following:

1st: teacher warning and student will receive 2/10 participation points for walking entire hour. If the student must be warned to continue his/her walking they will be removed from class with an office referral and receive 0/10 points.

2nd: parental contact and office referral and student will receive 2/10 participation points for walking entire hour, (no walking = 0/10 + office referral)

3rd: parental contact, parental meeting, and office referral and student will receive 2/10 participation points for walking entire hour, (no walking = 0/10 + office referral)

4th: parental contact, signed behavioral contract and student will receive 2/10 participation points for walking entire hour, (no walking = 0/10 + office referral)

5th: Dropped for the SEMESTER with F

*There is no reason for a “no dress” as there are rentals available on a needs basis.

Attendance: Students must be in attendance in order to accomplish course objectives. Please see the make up policy below for excused absences and unexcused absences.

Make Up Policy

When students cannot be in attendance for class, we expect that they will make up this workout time they have missed. Any absent date, excused or unexcused, will result in a 0/10 participation grade. YOU MUST BE PRESENT TO PARTICIPATE. Students can only make up these participation points by obtaining a make up form from their instructor and completing the criteria outlined. Make-ups must be completed no more than 5 school days upon return or the amount of days gone, unless directed otherwise by a physician or school nurse. The only make ups that can be earned are: unexcused absences, excused absences, ISS, and OSS dates. All other point loss including “no dresses”, strikes on participation, and behavior removal MAY NOT BE MADE UP. If you choose to lose points, you do not get to make them up. All students will be given 5 freebie days to be absent from PE class per semester for any reason. The first 5 days absent from PE class per semester will not affect your grade. Every day over the 5 dates given you will be required to choose a make-up opportunity to earn your points back. For example, if you are sick an entire week, you have not lost any points. The following week you go on a field trip on Tuesday, but you are present every other day, you have lost 10 points. Being absent for PE includes: nurse’s notes, doctor’s notes, field trips, participation in extra curricular activities, being sick, or any other dates you are not physically in class.

-          Passes out of the office will not count as being absent

 

Make Up Options (3)

Physical Portion: Worth up to 10 of the 10 points possible.

·         A 30 minute cardiovascular workout in your target heart rate zone must be completed after school in the weight room. This must be arranged through your current physical education instructor.

Physical Portion: Worth up to 5 of the 10 points possible.

·         A double cardiovascular workout in your target heart rate zone must be completed during your physical education hour only in the weight room or the outdoor track. This must be arranged through your current physical education instructor.

Written Portion: Worth up to 10 of the 10 points possible.

*May not exceed 15 written papers throughout the year*

 

·         Choose a motivational quote from the following list that inspires you.

-          Write a two page paper (12 font double spaced with 1" margins)

-          Paper must include how you plan to apply the quote to your life and how it also applies to performance in physical education/workouts.

1.       In winning, total commitment is necessary. (Jeff Davis)

2.       Success is not a sometimes thing. In other words, you don't do what is right once in awhile, but all the time. Success is a habit. Winning is a habit. (Vince Lombardi)

3.       Whatever you do, don't do it halfway. (Anonymous)

4.       Always keep your composure. You can't score from the penalty box; and to win, you have to score. (Bobby Hull)

5.       Only those who have the patience to do simple things perfectly will acquire the skill to do difficult things easily. (Anonymous)

6.       You must be the change you wish to see in the world. (Ghandi)

7.       It is easier to do a good job than to explain why you did not. (Anonymous)

8.       The problem is not that people don't know what to do. The problem is they find reasons not to do it until there are no tomorrows. (Anonymous)

9.       Good leaders were once great followers (Anonymous)

10.    Winning isn't everything, but making the effort to win is. (Vince Lombardi)

11.    There is no failure except in no longer trying. (Elbert Hubbard)

12.    Good is the enemy of great. (Jim Collins)

13.    The difference between good and great is a little extra effort. (Anonymous)

14.    It's amazing how much can be accomplished if no one cares who gets the credit (?)

15.    Pride is the extra things you do when no one else is watching (?)

***Note from home/nurse: Notes from home/ nurse will be accepted for a maximum of three consecutive days, after the 3rd day you must have a note from a physician. Please take your note directly to the school nurse. These absent dates will be counted towards your 5 freebie days.

Tardies: Students must be in the PE hallway by the sound of the tardy bell. Consequences will follow the student handbook. Students are also required to be dressed and in the PE hallway 5 minutes into class. Strikes will be given as consequences and will be assigned based on how much activity you have missed.

 

 

Fitness Testing: All 9-12th grade students will be assessed using the six recommended FITNESSGRAM tests. We will assess students’ fitness levels 6 times throughout the year. Tests include: (1) PACER- cardiovascular endurance, (2) Body Mass Index reads- height and weight of student calculated into Body Composition (results will be confidential) , (3) Curl-Ups- abdominal test to measure strength and endurance, (4) Trunk Lift-  measures strength of student’s lower back, (5) Push-Ups- measures students upper body strength, and (6) Back Saver Sit-n-Reach- measures the flexibility of lower back and hamstrings.

 

Written Test/Assessment: Junior and Senior PE will be assessed through 2 written tests administered per quarter, 25 points per test. Freshman and Sophomore PE will be assessed through 2 written tests administered per quarter, 25 points per test. Assessments may include: written tests, quizzes, and/or alternative assessments. Junior/Senior PE the following eight units will be your study guides for each test:

 

UNIT 1: FITNESS ACROSS THE P.E. CURRICULUM Test #1

 

Components & Benefits of Fitness

Five Health-Related Fitness components:

Cardiovascular Endurance the ability of the heart, blood vessels, and lungs to supply oxygen to the working muscles

Cardiovascular activities are those that increase the heart rate in the training zone for an extended period of time. The intensity of activities generally should be between 60% to

85% of a person’s heart rate range.

Muscular Strength the ability of the muscles to exert a force

Muscles become stronger when they are exercised against a gradually increasing resistance, or weight. Muscles may adapt by getting bigger (hypertrophy) or smaller (atrophy) depending upon how often and how hard they are used.

Muscular Endurance the ability to efficiently use muscles over a longer period of time.

While muscular strength allows you to lift more weight, muscular endurance allows you to lift more repetitions. Common tests for muscular endurance are push-ups, sit-ups, pull-ups, and dips.

Flexibility the ability to move at the joints through a full range of motion

A regular program of stretching may incorporate static (stationary) stretching and/or dynamic (movement) stretching to improve flexibility. Stretching should be done when the body is warm and should be held to the point of mild discomfort, not pain (and not abrupt bouncing).

Body Composition the amount of body weight that is fat compared to muscles, bones, and other body tissues

Body fat with-in a normal range promotes healthy body functioning.

A recommended range for males is 12% - 18%, for females 18% - 24%.

Major benefits of good Physical Fitness:

Improved appearance

Increased energy levels

Increased self esteem and confidence

Stronger and more efficient heart

Increased capacity to do physical work, including sport performance

Injuries are less frequent, less severe, and recovery time is shorter

Improved emotional control

Sleep better (and therefore more energized throughout the day)

Body fat stays within normal healthy range

Increased life expectancy / enjoy more healthy years

 

UNIT 2: FITNESS ACROSS THE P.E. CURRICULUM Test #2

Cardiovascular Exercise Training

Cardiovascular Endurance: The ability to persist in physical activities that rely

on the heart, blood vessels, and lungs to supply oxygen to the working muscles

Cardiovascular Activities all have 4 characteristics:

Large Muscle Groups the larger the muscle mass involved, the better the

activity. Whole body and weight baring, the best.

Rhythmic you can regulate the pacing of the activity (slow down or speed up) and still perform the exact task.

Continuous the activity is sustained over time

Aerobic the nature of the activity is dependant upon the strength and efficiency of the heart supplying oxygen

Examples of Cardiovascular exercise activities:

Swimming, biking, walking, running, rowing, cross-country skiing, aerobic dance, etc.

Benefits of Cardiovascular exercise:

Stronger and more efficient heart (increase stroke volume)

Lower heart rate at rest, during exercise, and recovery

Lower blood pressure at rest, during exercise, and recovery

Lower cholesterol (lower total, raise HDL)

Improved body composition, burn fat

Improved ability to perform work, faster recovery

Maintenance of a healthy heart and cardiovascular system

*Guidelines for how to maintain or improve cardiovascular endurance:

*Frequency How often should you do CV exercise?

3-5 times per week

*Intensity How hard (vigorous/intense) should CV exercise be?

Between 60% - 85% of your Heart Rate Range

*Time (duration) How long should CV workouts last?

20-60 minutes

*Progression – a gradual increase of frequency, intensity, and time as a person’s fitness level improves

 

UNIT 3: FITNESS ACROSS THE P.E. CURRICULUM Test #3

Aerobic & Anaerobic Activity, CHD Risk Factor Reduction

Aerobic activity:

It is activity that is dependent upon the heart, lungs, and blood vessels to transport oxygen to use as fuel to the working muscles. It is generally large muscle activities that are sustained for relatively long periods of time

Examples of aerobic activity:

Group I activities – [provide constant intensity, not dependent upon skill]

Cycling, jogging, running, walking, rowing, stairclimbing, elliptical trainer

Group II activities – [may provide constant or variable intensity, depending on skill]

Aerobic dancing, bench step aerobics, Nordic skiing (outdoors), hiking,

In-line skating, rope skipping, swimming, water aerobics

Group III activities – [provide variable intensity and are highly dependent on skill]

Basketball, country dancing, handball, racquet sports, volleyball, circuit resist tng.

Anaerobic activity:

It is activity done in short bursts of intense movement whereas the body cannot supply blood and oxygen to the muscles as fast as the muscles use it. The immediate sources of energy

(ATP & PC) stored in the muscle allow for quick short bursts lasting no more than 20 to 30 seconds. The oxygen demand for the activity is beyond what the body can sustain.

Examples of anaerobic activity:

Most sports are a combination of aerobic and anaerobic exercise. Examples of pure anaerobic exercises are: short sprints, weight lifting, high jump, diving, throwing a baseball, gymnastics vaulting, etc.

CHD Risk Factors:

[The greater the number and severity of risk factors, the greater the probability of CHD]

CIGARETTE SMOKING - Everyday 3000 young people in US become smokers; closely linked to lung cancer, pulmonary disorders, & CHD; smokers have more than twice the risk of heart attacks.

OBESITY AND OVERWEIGHT –20% above desirable weight; 1 of 3 adults; 1 of 5 children & adolescents; can lead to a variety of health problems – cholesterol, BP, diabetes, cancers, pulmonary, & orthopedic. Exercise and nutrition counseling to combat problem

PHYSICAL INACTIVITY – Physically active people have lower incidences of heart attacks and death from CHD and tend to develop CHD at a later age compared to their sedentary counterparts.

HYPERTENSION (high blood pressure)– above 140/90 ; 1 in 4 adults in USA; narrowing of blood vessels; causes heart to work harder than it should which leads to heart failure; regular exercise can lower high blood pressure.

HIGH CHOLESTEROL – young adult should be under 180 for total cholesterol; diets high in fat elevate cholesterol; causes the formation of plaque on arterial walls; exercise elevates HDLs which pick up excess cholesterol in the arterial walls and metabolizes it in the liver.

DIABETES MELLITUS – the pancreas fails to make enough insulin to regulate the amount of glucose in the blood or when the body cells become resistant to insulin. Diabetes is becoming much more common in young adults, especially in the overweight

AGE – regular physicals as you age, the more risk factors the earlier the checkups.

FAMILY HISTORY – strong genetic link to CHD. Regular exercise, proper diet, and regular checkups are best prevention; early detection and treatment recommended.

 

UNIT 4: FITNESS ACROSS THE P.E. CURRICULUM Test #4

Muscular Strength and Strength Training

Muscular Strength: The maximum force that can be generated by a specific muscle or muscle group

Muscular Endurance: The ability of a muscle group to execute repeated contractions (i.e. perform work) over a sufficient time period to cause muscular fatigue.

Benefits of Muscular Fitness:

Ability to do more strenuous work Ability to do more work over a longer period of time

Less susceptible to muscular fatigue Less injury prone

Improved appearance Improved athletic performance

Proper Form / Technique for Strength Training:

Balanced Athletic Position

Intended Muscles Move; Other Muscles Stabilize

Full Range of Motion

Smooth Controlled Movement

Complete Eccentric and Concentric Muscle Actions

Proper Breathing

SIX ABSOLUTES for Proper Lifting Technique (Free Weights):

ATHLETIC or JUMP STANCE - Balanced “ready” position

BE TALL - “Power Line” position with back in correct position

SPREAD THE CHEST lower back lock-in concave position

TOES ALIGNED straight ahead stance, groove strength for athletic position

KNEES ALIGNED directly over toes, balance on entire foot, heels stay down

EYES ON TARGET – straight ahead or up, awareness of correct body position

How much weight should you use? How many sets? How many repetitions?

For strength gains to occur, the weight needs to be at least 60% of one’s maximum for each lift.

A maximum conversion chart is used to predict maximums based on repetitions performed at sub-maximum workloads.

Generally, if strength and size is desired, heavier weights with 3 sets of 6-8 repetitions. If muscle toning and definition is desired, lighter weights with 2-3 sets of 10-15 repetitions. Keep in mind that there are many individual differences in how each person will respond, including significant differences between the males and females. Many studies have shown strength gains utilizing a variety of programs. In other words, a regular program of weight training results in strength gains regardless of the exact protocol. A statistical comparison of many studies shows most strength gains close to the 3 set x 6 rep standards.

A minimum of one set of at least one exercise for all major muscle groups should be included in a training session for persons training for general fitness. This recommendation is for healthy adults desiring minimal fitness and not for athletes because multiple sets do result in greater strength gains than single-set programs.

 

UNIT 5: FITNESS ACROSS THE P.E. CURRICULUM Test #5

Strength Training Principles

Progressive Overload is the practice of continually increasing the stress placed on the muscle as it becomes capable of producing greater force or has more endurance if a person’s body gets stronger and can perform the same weight, sets, and reps easier, no further gains in strength will occur if the training stimulus does not increase.

*A reasonable guideline is 2.5% to 5% increases at any one time.

In other words, prove that you can handle it using:

1. Good Form, and

2. An adequate numbers of sets and reps, and then increase the resistance.

The exercise order can have a significant impact on the training stimulus stress level in a training session. By exercising the larger muscle groups first, the greatest possible training stimulus is presented to all of the muscles involved in an exercise. The exercises performed in the beginning of the workout are the ones that require the greatest amount of muscle mass to perform. Thus, this ordering scheme focuses on gaining a greater training effect for the large muscle groups.

Intensity is the percentage of the 1RM (repetition maximum) or any RM for the exercise.

If someone’s 1RM bench press is 200 lbs., that person’s 75% intensity of their 1RM would be

150 lbs. The minimal intensity that can be used to perform a set to momentary voluntary fatigue to result in increased strength is 60% to 65% of the 1RM.

[In other words, performing a large number of reps with a very light resistance will result in no strength gain.]

Training to failure: In order to make significant strength gains, temporary muscular failure, has to occur somewhere in the set. This may be in a 1RM or in the last couple repetitions in a 10RM.

Specificity in strength training implies that the training for a specific sport should include the types of muscle actions encountered in that sport. It should also include speed specificity in that resistance training should be performed at the velocity required during the actual sporting event. This is high velocity for most sports. It should also include energy-source specificity, in that the number of sets and reps and the length of rest periods between sets and exercises need to be appropriate for the energy source in which training adaptations are desired.

Periodization is variation in the training volume and intensity. It is extremely important for optimal gains in strength. Generally, in strength training, periodization is a plan of lifting that covers 8 to 12 weeks. Within this time period, a lifter varies his weight, sets, and rep combination to achieve a certain level of performance at the end of the time period. It may involve lighter weights and more reps at the beginning of the cycle and then gradually increasing weights and decreasing reps as time goes by. The intention is for the lifter to peak with maximum strength gains at the end of the cycle.

 

 

 

 

UNIT 6: FITNESS ACROSS THE P.E. CURRICULUM Test #6

Body Composition and Exercise

Body Composition: the relative comparison of body fat to lean body mass (muscle, bone, organs). Fat weight compared to fat free weight.

Purpose and functions of fat:

Normal physiological functioning

Protection of organs from bodily harm

Insulation and body temperature regulation

Energy storage

Methods of Measuring or Estimating Body Composition:

Skinfold – caliper measures fat tissue at specific landmarks

Underwater Weighing – weight in water relative to body volume

Bioelectrical impedance – speed of electrical impulse faster in muscle

Body mass index & height/weight chart – has limitations

What % of body fat is recommended?

Males = 12% – 18% Females = 18% - 24%

Fat levels above recommended values are associated with health problems – orthopedic, cardiovascular, metabolic, etc.

Healthy and Long-term Method of Weight Control:

Proper Diet: to provide the necessary nutrients for peak physiological functioning

Exercise: to maintain higher metabolic rate and provide health benefits

Most health professionals agree that diet and cardiovascular exercise are the standard method for weight loss. However, the role of strength training is fast becoming a new piece of the weight control and weight loss method.

In general, a person with a higher muscle mass has a higher metabolism (burns more calories throughout the day). Strength training during a weight loss regime helps insure that the weight that is lost is more fat weight rather than a combination of fat and some muscle. Cardiovascular exercise will always be the primary choice for exercise. However, strength training helps to compliment the total plan.

A healthy combination of cardiovascular training and strength training can provide you the benefits of each. Cardiovascular exercise generally burns more calories throughout the activity, but strength training can promote more calories burned for up to two hours following a workout.

 

UNIT 7: FITNESS ACROSS THE P.E. CURRICULUM Test #7

Exercise and Sport Nutrition

CALORIES IN CALORIES OUT = NET CALORIC BALANCE

(food & drink) – (exercise, physical activity, metabolism) = -,+, same

Estimated metabolism:

Males: body weight (lbs.) x 11 = calories burned

Females: body weight (lbs.) x 10 = calories burned

Regular exercise serves to maintain a higher level of metabolism, burning calories throughout the day. Diet alone (calorie restriction) gradually lowers or slows metabolism resulting in the body burning fewer calories throughout the day. Thus, exercise should be a major component of any weight loss or weight control program. In addition to the weight loss benefits, exercise also provides countless health related benefits.

Carbohydrates:

Complex carbohydrates (high in nutrients) vs. Simple carbohydrates (low in nutrients)

Fruits, vegetables, whole grains (highly nutritious foods)

Primary energy source for the body

4 calories per gram (complex carbohydrates provide low calorie with high nutrition)

60% - 70% of calories in diet should be carbohydrates (AHA)

Average American diet has only 50% or less of calories from carbohydrates

Fats:

Animal products, meats, poultry, whole milk dairy, vegetable oils, metabolizes vitamins, converts to body fat, essential to proper functioning, 9 calories per gram (many calories from even a small amount) only 20% - 30% of calories in diet should be fat (AHA)

Average American diet is high in fat (40%-50% of calories are fat)

Protein:

Meats, poultry, fish, dairy products, eggs, nuts, soy

Amino acids to build muscle, tissue, hormones, and enzymes

4 calories per gram (provides low calories with high nutrition)

12% - 15% of calories in diet should be protein(AHA);

Average American diet is slightly high in protein (15% - 20% of calories)

All calories that the body can not absorb and utilize are excess calories.

Excess calories, regardless of quality, will be converted to body fat or waste products.

Athletes and protein: The body will only utilize up to one gram of protein for every pound of body weight. Excess protein converts to body fat and waste.

Post exercise nutrition: The body should be refueled with quality nutrients as soon as possible following exercise. This nutrition aids in the recovery and rebuilding process.

Purposeful weight gain should be in the form of muscle weight and strength development. Body fat will be lost with improvement in physical fitness. Strength improves performance

 

UNIT 8: FITNESS ACROSS THE P.E. CURRICULUM Test #8

Flexibility Training, Fitness Centers, & Personal Training

Flexibility – the ability to move a joint through normal range of motion

Benefits of good Flexibility:

Improves physical and athletic performance

Decreases the frequency and severity of injuries

Decreases muscle soreness and recovery time

Joint health – insures long term benefits of mobility

Improves posture and prevents low back pain and injuries

Relaxation and stress management

Flexibility Training Guidelines:

Use a variety of stretching modes such as dynamic, static, or PNF stretching

Perform at least one major stretch for each major muscle group of the body

Problem areas should get 2 or more stretches – lower back, hamstrings, hips, and legs

Warm-up first, then stretches. Stretch when the muscles are warm

Stretch to the point of mild discomfort, not pain

Hold a stretch 10 to 30 seconds, rest for 30 to 60 seconds, repeat

Stretch both sides of the body and opposing muscle groups

Stretch the target muscle groups in different planes to improve overall range of motion at the joint

Increase intensity and duration gradually over time, stretching is non-competitive

Choosing a fitness center for membership:

Consider your personal goals and objectives

Do they offer what you are interested in?

Convenience? Is it located within 3 miles of home? Work?

Friendly/Motivating Atmosphere? Social atmosphere?

Price? How often would you use it? Is it worth it?

Service? Are they strong on service or do they just want your money?

Programming? What do they have besides open workout? Classes? Personal

Training? Leagues? Fitness Testing? Clubs? Education? Child Care? Special Events? Social

Events? Spa Services? Fitness Incentives?

Equipment? What type of equipment is there? How well is it maintained?

Staff? Qualifications of Staff? Responsibilities of Staff? Helpfulness of staff?

Cleanliness of Facility? Business and Financial Stability? Types of memberships?

General appearance? History of business?

What qualifications should you look for in a personal trainer?

Formal Education and Degree(s) in field applicable to exercise training

Certifications from a reputable organization (not a weekend workshop course)

Experience as a fitness professional, not as an athlete. Experience at instruction.

People Skills

Motivating

Safe, Insured, Licensed (Be a smart consumer)

 

 

I have read and fully understand all the rules, regulations, attendance procedures, and grading policies listed on the MCHS Physical Education syllabus.  This sheet due to your PE teacher by Friday, August 21st 2009.

Student Name (printed): _____________________                                             Date signed: ____________

 

_____________________________                                                         ___________________________________

Student Signature                                                                                Parent Signature