Snoqualmie Valley School District Physical Education Waiver Form A Student Form

Transcription

1 Snoqualmie Valley School District Physical Education Waiver Form A Student Form Student must have completed 1.0 credit (2 sem) of Physical Education before applying for a waiver. Requests must be submitted to the PE Department Chair by March 31 st of their junior year once they have registered for their senior year. Students must attach a copy of their transcript grades 9-12 and must have a full schedule their senior year if waiver is granted. DO NOT RETURN THIS FORM TO COUNSELING CENTER OR MAIN OFFICE. RETURN TO ROOM 118 to Mrs. Stewart. Application date: Name: Current Grade: Graduation Year: Physical education classes completed:! Class title Year Completed Grade Earned Credit Earned! Class title Year Completed Grade Earned Credit Earned *1 semester is equal to.5 credit Have you received a waiver in physical education?! Yes, semester waived (e.g., Second Semester, Sophomore Year)! No Check all that apply:! Enrolled as a Teacher s Aid or Tudor.! Failed physical education at any time in high school.! Have you had any open periods (e.g., late arrival, early dismissal)? Check the appropriate box for waiver request: RCW 28A ) The following six categories qualify as allowable reasons for the school to consider waiving physical education:! Physical Disability Attach verification from doctor indicating that participation in a physical education class will be detrimental to student s health and that your special circumstances CAN NOT be accommodated or modified. In most cases a student with a physical disability can participate in a limited fitness program and is rarely granted a waiver.! Religious Belief Attach a note from parent/guardian if religion does not allow participation in physical education.! Employment* Attach verification from employer including dates and times of employment. For financial reasons, student must work during school hours.! Directed Athletics* - Participation in school district extra- curricular athletic program. Student must complete 2 seasons. MSHS SPORTS PLAYED DATES Coach Signature! Military Science & Tactics (while in school)! Other Good Cause* - Please explain: * Exclusions for Physical Education Waivers: A student is not eligible for a PE waiver if one or more of the following apply: Position as a Teacher s Aide or Tutor Student has an open period (e.g., late arrival, early dismissal) Previous failure of a high school physical education class Rationale Meeting a high school graduation requirement has a higher priority over serving as a teacher s aide, office assistant or use of an open period or taking another elective. PE classes are offered during the summer for credit as well as zero period. I can t fit it in my schedule is not a reason to waive your PE credit. Be sure to plan ahead when deciding how you will fulfil this state requirement. I understand that if the Physical Education Waiver Application is approved, I will be required to take a written test and/or complete portfolio requirements according to district policy. (Signature of Student) MSHS Building Use Only (Signature of Parent/Guardian)! Approved! Not Approved (Physical Education Department Chair) Date

2 Snoqualmie Valley School District Physical Education Waiver Form B District/Building Form This form is to be completed by the Physical Education Department Head. Student Name: School: The student is applying for:! Physical Education Waiver The student has: 1. Provided a copy of Form A.! Yes! No 2. Met proficiency/competency in one or more of the following (check appropriate box).! OSPI- developed fitness assessment: Concepts of Health and Fitness (at 80% or higher)! Fitness Planning (at 80% or higher)! Fitness Plan/Portfolio (at 80% or higher) MSHS Building Use Only! Waiver requirements met! Waiver requirements not met Completed form will be kept with student records. (Department Chair)

3 Mount Si High School Health and Fitness Requirements Office of Superintendent of Public Instruction State Statutes for Health & Fitness High School Graduation Requirements Health education (.5 credit) and physical education (1.5 credits) Minimum requirements for graduation (WAC ) Assessments for Health and Fitness formerly known as Classroom-Based Assessments (CBAs) Emphasizes alignment with state health and fitness learning standards and assessments Essential academic learning requirements and assessments (RCW 28A ) Waivers in Physical Education outlines parameters for excused physical education Physical education in grades 1 8 (RCW 28A ) Physical education in high schools (RCW 28A ) Physical Education Requirements outlines physical education and equivalency credits Excuse from physical education requirement (WAC ) WAC ) Special Education Students explains services available to PE students receiving FAPE Special education/physical education (WAC A-02030) Nutrition and Physical Activity emphasizes the goals for wellness policies Access to nutritious foods and exercise (RCW 28A ) Food choice, physical activity, childhood fitness (RCW 28A ) Basic Education Act Expectations for what students should know and be able to do by the end of their K-12 education. Basic education act Goal (RCW 28A ) Basic education act Program contents (RCW 28A ) Powers and duties (RCW 28A ) Washington s K-12 Health and Fitness State Learning Standards focus on what students should know and be able to do. High quality physical education instruction contributes to good health, develops fundamental and advanced motor skills, improves students self-confidence, and provides opportunities for increased levels of physical fitness that are associated with high academic achievement.

4 Physical Education Waivers The Washington State graduation requirement for Physical Education is 1.5 credits, which is 3 semesters (0.5 each). Students may request a waiver in MARCH prior to registration of your senior year so that an entire four-year set of class choices can be reviewed. Students who have had partial schedules, office or class TA s, tutors, or have ever failed a physical education class, will not be eligible for a waiver. It is important to know that any student requesting a waiver must take a written state requirement called a Classroom Based Assessment for Physical Education which will be arranged by the Physical Education department chair. Students who choose this option are still expected to earn 1.0 (2 semesters) of Physical Education credit through the regularly scheduled high school course offerings at Mt Si High School. Health may not be waived. (WAC ) MSHS SCHOOL-DIRECTED ATHLETICS: Students engaged in school-directed athletics can waive up to 0.5 credit toward the PE graduation requirements. Students who choose this option are still expected to earn 1.0 Physical Education credit through the regularly scheduled high school course offerings. Successful completion of 2 full seasons in consultation with their guidance counselor. Student must complete entire sports season. Two sport seasons equal 0.5 PE waiver, which is the maximum allowable for a school waiver. All forms required are on the MSHS website under information/forms. Students can have a Physical Education requirement waived related to: physical disability, religious beliefs, military, and school sponsored athletic programs (RCW 28A WAC * Students who have had partial schedules, TA s, tutors, or have ever failed a physical education class, will not be eligible for a waiver. Physical Education credit can be earned in several ways. I can t fit it in my schedule, WILL NOT be accepted as a reason to waive PE. 1. Participation in a physical education class at MSHS during regular school hours. 2. Zero period weight training. 3. Completion of a sports season at MSHS can earn you 0.25 PE waiver for each season up to a maximum of two seasons (0.5 total). Athlete must complete season. 4. Summer School Physical Education classes at MSHS will allow students to earn.5 PE credit in a two week period. Students will attend classes from 7:30-4:00 pm, five days a week for two weeks. See the SVSD website for more information. 5. Bellevue College offers many Physical Education courses which can be taken as a Running Start or Summer Enrichment student. Each two-credit Bellevue College Physical Education course earns a student 0.5 high school PE credit. 6. Physical Education online through the counseling office.

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