Schoolwires
WMHS Physical Education Student Profile and Course Agreement Sheet
I have read and reviewed the policies and guidelines for Physical Education at William Monroe High School. I acknowledge that I will be held accountable for the rules and polices stated within the course information sheet..
Student’ Name (print) ___________________________________________________________________
Student’s Signature _____________________________________________________________________
Parent/Guardian Verification
Parent/Guardian Name (print) ____________________________________________________________
Signature _________________________________________________________________
Relationship to student ________________________________ Date _________________
Parent Information
Home Phone # _________________________ Work Phone # _________________________
Cell Phone # __________________________________________________________________________
e-mail ________________________________________________________________________________
Pre-Existing Medical Conditions
Are there any pre-existing medical conditions that your son/daughter has to which I should be alerted? Examples may include (but not be limited to) severe allergy to bee stings (requires an epi-pen), asthma (needs inhaler), under a physicians care (recent surgery due to illness or injury). Please describe what we need to know about your child while in PE.
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|**If a doctor is requiring you to spend an extended period of time out of regular physical education class, you will need to bring in a list of rehabilitation exercises |
|in which the doctor would like you to participate! |
Possible Consequences for inappropriate student actions:
Warning to student
Contact Parents by email or phone
Teacher assigned Detention
Referral to appropriate assistant principle
Refusal to participate in an activity will result in immediate dismissal from the gym with a referral.
| |Notes from Parents |Dressing out warnings to Parents |Other Parent Contacts: |
| |Note #1 |Note #2 |Note #3 | | |
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|1st Quarter | | | | | |
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|2nd Quarter | | | | | |
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|3rd Quarter | | | | | |
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|4th Quarter | | | | | |
For Office use only:
Doctors Notes:
|Date of Note |Date to return to activity|Alternate Activities: |
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Daily Comments/Concerns:
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