NAME _________________________________________ CLASS _________________________ GRADE ________

ON THE BENCH IN PE Worksheet

Directions: Since you are unable to participate in PE today, please answer the following questions while you
are sitting out.

1.) Why did you have to sit out during PE today?

a. _______ I did not wear the right shoes (My PE day is: 1 2 3 4)
b. _______ I am sick or injured
c. _______ I am in a time-out
d. _______ Another reason (please explain)

2.) Please explain with words or draw a picture below, or on the back of this worksheet explaining why you
are sitting out.

3.) What activities are we doing in Physical Education today?

Dear Parents

This is a great system I use in order to cut down on the time I spend dealing with students who are unable to participate in Physical
Education. I believe it increases parent communication and gives students some accountability. My students are instructed th at
when they walk into the gym with inappropriate shoes or are injured/not feeling well they go directly to the wall, take a clipboard
and pencil and fill out the form. This decreases distraction for me and steam lines the beginning of the lesson. I will add that as a PE
teacher my main goal is to create active kids. For this reason as long as the shoes are not a safety concern I usually let the student
participate after filling out the form. This way you still get a note from me about your student being unprepared and the st udent
still gets to learn the content and participate in the activity. Please sign this form and return it to Mrs. Kubel.

Parent Signature __________________________________________________________________________