LOURDES COLLEGE INC

Cagayan De Oro City, Misamis Oriental, Philippines

INDIVIDUAL ACTIVITY PLAN

Name of Student: Batch:

Name of Instructor: MAC ALFRED B. MALACAT, LPT, MAED

Title of Activity: Physical Training and Body Fitness

Type of Activity: ⎕ Individual ⎕ Group

Strand (Please check all applicable):

⎕ Service ⎕ Action ⎕ Creativity ⎕ Leadership

Outcomes (Please check all applicable):

⎕ 1. Increased awareness of their own strengths and areas for growth

⎕ 2. Undertaken new challenges

⎕ 3. Introduced and managed activities

⎕ 4. Contributed actively in group activities

⎕ 5. Demonstrated perseverance and commitment in their activities

⎕ 6. Engaged with issues of global importance

⎕ 7. Reflected on the ethical consequence of their actions

⎕ 8. Developed new skills

Start End

Planning Dates (mm-dd-yyyy):

Implementation Dates(mm-dd-yyyy):

Venue: Home

I. General Description of Activity. Amidst the pandemic, students are becoming more uneventful and spiritless

II. Objectives. This activity aims to promote one's lifestyle and to have a healthy body during this pandemic.

PSHS-00-F-DSA-13-Ver02-Rev0-02/01/20
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III. Persons Involved
Adult Supervisor/s and Collaborators

Name (mark with * if Designation/ Company/Organization/ Contact number and

adult supervisor) Position Affiliation Email

Other PE 2 students involved (all students)

Name Role in Activity Department Adviser/Dean

IV. Materials and Resources Needed

Qty Items Unit Cost Amount

Total
0

PSHS-00-F-DSA-13-Ver02-Rev0-02/01/20
V. Activity Risk Assessment
Potential Hazards1/Risks2 Identified Safety Precautions
Regulate the training time based on the
Exhaustion/Overexercising
capabilities of the student
Always bring water during training sessions
Dehydration/Not drinking sufficient amount of water
and take breaks.

1
Hazard is anything that could cause harm
2
Risk is the chance that someone will be harmed by the hazard

Prepared by:
Signature of Student Date Prepared

CERTIFICATION:

I certify that I have understood the potential hazards and risks that may be encountered by my
child/ ward, as well as the benefits that my child/ ward will be getting from the said activity.

I certify that I have understood the projected expenses that will be incurred, as well as the benefits
that my child / ward will be getting from the said activity.

With these knowledge, I am allowing him/her to undertake the said SCALE activity as part of
his/her SCALE program.

Name and Signature of Parent / Guardian Date Reviewed

Reviewed and
Approved by:
Name and Signature Supervisor Date Approved

PSHS-00-F-DSA-13-Ver02-Rev0-02/01/20
PSHS-00-F-DSA-13-Ver02-Rev0-02/01/20
PSHS-00-F-DSA-13-Ver02-Rev0-02/01/20
PSHS-00-F-DSA-13-Ver02-Rev0-02/01/20