PHYSICAL FITNESS CHECKLIST

Directions: With all sincerity, assess your personal physical fitness level based on your capacity and previous
performance in fitness tests in senior high school. Put a check mark (  ) on the column that best describe your
judgment. Do not skip a single component.

HEALTH – RELATED FITNESS

COMPONENT Obese Overweight Normal Range Underweight
Body Composition 
(How would you assess your
current weight?)
COMPONENT Excellent Good Average Poor
Cardiorespiratory Endurance 
(How would you assess your
performance in a 5 minute
continuous run?)
Flexibility 
(How would you assess your
performance in a sit and reach
test?)
Muscular Strength 
(How would you assess your
performance in a 90 seconds
plank test?)
Muscular Endurance 
((How would you assess your
performance in wall sit test?
How much time can stay in the
position of wall sit?)
SKILL – RELATED FITNESS
COMPONENT Excellent Good Average Poor
Coordination 
(How would you assess your
performance in hand – eye test?
How many attempts can you
catch a ball using alternate
hands?)
Power 
(How would you assess your
performance in standing long
jump?)
Agility 
(How would you assess your

Name:_______________________________________ Course & Section:__________________

 PHYSICAL FITNESS CHECKLIST
performance hand – eye test?)
Speed 
(How would you assess your
performance in 50 meter
sprint?)
Balance 
(How would you assess your
performance in stork balance
test?)
Reaction Time 
(How would you assess your
performance in ruler drop?)
_3_ / 10 _3_ / 10 _4_ / 10 _0_ / 10
(How many (How many good (How many (How many poor
TOTAL NUMBER excellent check check marks do average check check marks do
marks do you you have?) marks do you you have?)
have?) have?)

Based on the assessment of your personal physical fitness level, answer the following questions:

1. Enumerate the components which are your strengths (components assessed as excellent)
Mascullar Strenght
Coordination
Agility

2. Enumerate the components which are your weaknesses (components assessed as poor)

Non

3. Enumerate the components which you need to enhance (components assessed as good and average)

Cardiorespiratory Endurance
Power
Speed

4. How do you plan to improve your weaknesses? Answer this question in 3 TO 5 SENTENCES
ONLY.
Maybe I will face my weaknesses in everytime to prove to my self that I can take my weaknesses to
become strength someday and become successful also.

Name:_______________________________________ Course & Section:__________________

 PHYSICAL FITNESS CHECKLIST

Orsua, Charles Angel P EE-201

Scoring Rubric:

Rubric for Assessment of Personal Fitness (20 points)

10 8 6 4 2
Assessment Provided 15 Provided 11 - 14 Provided 7 - 10 Provided 3 - 6 Provided 1 - 2
answers from the answers from the answers from the answers from the answers from the
checklist to the checklist to the checklist to the checklist to the checklist to the
essay questions essay questions essay questions essay questions essay questions
10 8 6 4 2
Punctuality in Submitted on or Submitted a day Submitted 2 days Submitted 3 days Submitted 4 days
submission before the due date after the due date after the due date after the due date after the due date

Name:_______________________________________ Course & Section:__________________