• MEDICAL/OSS REQUIREMENTS

     

     

    STUDENT NAME: ________________________

     

     

    PHYSICAL EDUCATION PERIOD: _________   LAB  _______________

     

     

    CURRENT PHYSICAL EDUCATION TEACHER: _____________________

     

     

    ASSIGNMENT:

     

                      ________ WRITING ASSESSMENT (5 PARAGRAPH ESSAY)

     

                                                          OR

                                       

    __________ STUDENT WAIVES THE RIGHT TO COMPLETE THE MEDICAL ASSIGNMENT AND AGREES TO MAKE UP CLASSES PHYSICALLY.  STUDENT MUST RECEIVE A PASS FROM THEIR PE TEACHER -  WHEN MAKE UP IS COMPLETE – IT MUST BE SIGNED BY PE TEACHER AND RETURNED TO MR. KNOEPPEL TO RECORD APPROPRIATELY.

     

     

     

    MEDICAL ASSIGNMENTS ARE EXPECTED TO BE COMPLETED AND RETURNED ON THE ISSUE DATE INDICATED BELOW. FAILURE TO COMPLY WILL RESULT IN A 10 POINT DEDUCTION FOR EACH DAY LATE.

     

    DATE GIVEN: __________

                     

    DUE DATE: ____________

     

    DATE RECEIVED: __________                           

     

     

                                        Students are only eligible to complete medical assignments if they are medically excused for 5 consecutive days.

     

     

     

    STUDENT SIGNATURE: _________________________

     

    TOPIC SELECTED: _____________________________

     

    **This form will be filled out by the student and teacher during the student's Physical Education Class