Rm 8-Pa: Sample Sign-Off Form For Completion Of Out-Of-Class Physical Activity Practicum


RM 8–PA: Sample Sign-off Form for Completion of
OUT-of-Class Physical Activity Practicum
(Form for Parent/Guardian)
Dear Parent/Guardian:
Please review this form and, upon agreement, provide your signature.
I _______________________________ parent/guardian of _____________________________
Name of Parent/Guardian
Name of Son/Daughter
do hereby certify and acknowledge the following:
My son/daughter has participated in the physical activities as selected for his/her
OUT-of-class physical activity practicum.
My son/daughter has accurately recorded his/her participation in the selected physical
activities for the OUT-of- class physical activity practicum.
Parent/Guardian Signature
Student Sign-off
I ________________________________
Name of Student
certify that this record is an accurate account of my physical activity participation in the
OUT-of-class physical activity practicum.
Student Signature
Date Received _____________________________________________________________________


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