In 2008, the Iowa Legislature enacted “the Healthy Kids Act,” requiring that all students in grades 6 – 12 engage in physical activity for a minimum of 120 minutes per week in which there are at least five days of school. The law also requires that we monitor how students fulfill this requirement.
Please fill out the items below, sign (both student and parent/guardian), and return to the school by ____________.
If you have any questions, call: 1-515-373-6619. (date)
Name of Student: ___________________________________________ Grade (___________):_____________
School year
School activities that student will be involved in during the __________ school year (include estimate of minutes per week):
FALL WINTER SPRING
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Cross country |
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Basketball |
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Track |
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Football |
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Wrestling |
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Golf |
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Volleyball |
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Bowling |
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Tennis |
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Swimming |
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Swimming (boys) |
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Soccer |
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Marching band |
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Show choir |
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Baseball |
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Cheerleading |
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Cheerleading |
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Softball |
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Drill team |
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Drill team |
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Pom squad |
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Trapshooting |
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Other* (what, when, how many minutes per week): |
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* Non-school activities (may include non-school sport teams, gymnastics, dance, individualized exercise program, etc.) that student will be involved in during the ____________ school year.
Signature of Student: ___________________________________________ Date Signed: _______________________________
Signature of Parent/Guardian: _______________________________________________________________________________
Signature of Building Principal: ______________________________________________________________________________
