ACTIVITY 3

Form 3 -A
PHYSICAL FITNESS TEST SCORE CARD
Name: Kurtney Iane Dialoma Sex: Female Age: 19 yo

CLASS #: PED001 Section: M2FEM Date: 11- 04 - 21

Direction: Perform the following activities to assess your fitness level. Make sure to
observe social distancing and other health and safety precautions.

Task 1: Health-Related Fitness Test

A. Body Composition: Body Mass Index (BMI)
Body Mass Index (BMI)
Height (meters) Weight (Kilograms) BMI Classification
157 m 49 kg 19.9 Normal

B. Cardiovascular Endurance: 3-Minute Step

Heart Rate per Minute
Before the Activity After the Activity
68 112

C. Muscular Endurance D. Muscle Strength

1. Push up 2. Basic Plank
Number of Push ups Time
21 42 .61 seconds

E. Flexibility
1. Zipper Test
Overlap/Gap (centimetres)
Right Left
9.5 cm 2 cm
Task 2: Skill-Related Fitness Test

A. Coordination:
1. Juggling Score: 1st trial:__15______
2nd trial:__30______
3rd trial:__25_____

B. Agility:
2. Hexagon Agility Test
Clockwise: Time (00:00) Counter clockwise: Time (00:00)
9.60 sec 8.70 sec

C. Speed:
3. 40 Meter Sprint Time: __4.7 sec__

D. Power: Standing Long Jump E. Balance: Stork Balance Stand Test

Distance (centimetres Right Foot: Time (00:00) Left Foot: Time(00:00)
First Trial Second Trial 57.22 sec 25.50 sec
1m/6cm 1m/ 8cm

F. Reaction Time: Stick/Ruler Drop Test

1st Trial 2nd Trial 3rd Trial
20 cm 4 cm 29 cm

G. Balance: Stork Stand

1st Trial 2nd Trial 3rd Trial
57.22 sec 30.39 sec 49.14 sec Right Foot
25.50 sec 10.39 15.60 Left Foot

Evaluator’s Name: Dialoma, Kurtney Iane

ACTIVITY 3
Form 3- B
INDIVIDUAL SCORE CARD(PRETEST) 

Name: Kurtney Iane Dialoma Gender: Female_Age: 19

Height: 157 m Body Weight: 49 kg BMI: _19.9_MHR: 201

Resting Pulse Rate (RPR): __68__ bpm (Before Step Test) 

Exercise Pulse Rate (EPR): __112_ bpm (After Step Test) 
Recovery Pulse Rate: ___87__ bpm (After 3 min) 
Target Heart Rate: 
Low Intensity 60-70 % __148____ to __161_ bpm 
Moderate Intensity 70-80% __161____ to __174____ bpm 
High Intensity 80-90% __174___ to ___188____ bpm 
Very High Intensity 90-100% __188____ to __201____ bpm 

___________________________________________________________________________________
RESULTS OF THE TESTS 
Station Test PRE-TEST
Score Remarks Tester Date
1 3-Minute Step 95 _____ 11-05-21
2 Stork Balance Stand 57.22 sec Excellent Marijune 11-05-21
Punay
3 Zipper Test 6cm Excellent Marijune 11-05-21
Punay
4 Planking 42 .61 _____ 11-05-21

seconds
5 Push up 21 Average 11-05-21
6 Hexagon Agility Test 9.60 sec Good 11-05-21
7 Standing Long Jump 1m/ 8cm Average Marijune 11-05-21
Punay
8 Juggling 30 Good 11-05-21
9 40 Meter Sprint 4.7 sec Average Nesta 11-05-21
Villasor
10 Stick/Ruler Drop Test 4 cm Excellent Nesta 11-05-21
Villasor