Bsa Physical Fitness Award Form printable pdf download

Ap plicat ion: BSA Physical Fitness Award

Name of applicant ____________________________________________________________________________________

Chartered organization ________________________________________________________________________________

Unit number ______ Check appropriate

Mentor

Scout

Unit leader

Council name ________________________________________________________________________________________

Name of mentor _____________________________________________________________________________________

The applicant named above has satisfactorily completed the BSA Physical Fitness Award requirements.

Signature ____________________________________________

(Mentor)

1. Complete a cardiovascular fitness evaluation/consultation with your personal health care provider. (This can be done as

part of the examination required by any council-approved class 3 medical evaluation.)

Note to healthcare provider: Subject to your professional discretion, it is recommended that the evaluation/consulta-

tion include a personal health history, a basic health data physical, and a discussion of health risk factors. No specific med-

ical studies or tests are required, but such may be included in the evaluation or examination based on professional

discretion and individual choice. The results of such studies or tests are for the use and information of the applicant and

provider only, and are not required for this application.

The required evaluation/consultation was completed on ___________________

Signature of healthcare provider __________________________

2. Give a presentation to a BSA or other community youth group (at least eight youth participants) on cardiovascular

fitness, diet, the health benefits of regular aerobic exercise, exercise recommendations for the Scout-age group, and

healthy lifestyles.

List of youth participants attending on _________________________________

(Date)

The required presentation was completed on ________________. Signature of mentor _____________________________

3. Review the BSA guidelines for the Athletics and other physical activity or personal fitness–oriented merit badge and

explain steps you have taken to follow each of the guidelines for the fitness goals. Explain precautions to be taken for a

physical fitness activity in each of the following: woods, fields, facilities, and waterfront.

The required explanations were completed on ________________. Signature of mentor ____________________________

4. Explain to your mentor the symptoms of dehydration and hypothermia. Explain the special considerations for preventing

dehydration and hypothermia.

The required consultation was completed on ________________. Signature of mentor _____________________________

5. Properly outfit for physical activities with proper equipment, clothing, and footwear. Know your own capabilities and

limitations. Illustrate how you would prepare for the physical fitness goals included in the award program.

The required presentation was completed on ________________. Signature of mentor _____________________________

6. With supervision from your mentor or other qualified person, set up a fitness goal–oriented plan using the seven major

components of fitness.

The required plan preparation was completed on ________________. Signature of mentor _________________________

7. Demonstrate your ability to improve your strength, posture, endurance, agility, speed, accuracy, and balance with your

own goal-oriented fitness plan.

The required evaluation was completed on ________________. Signature of mentor _______________________________

Completed all BSA Physical Fitness Award requirements on ________________.

Signature of mentor __________________________________________

Bsa Physical Fitness Award Form

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