NAI Physical Education Make-up Pass

Student Name:  ___________________________________     
PE Teacher:  ___________________________
Assigned PE Period:  ______________      A  /  B Day (Circle One)   

Make-up Time:        Before School:              _____________ (Start Time – End Time)
                                    Study Hall/Lunch:        _____________ (Period)
                                    After School:                _____________ (Start Time – End Time)

Activity Performed For Make-up:           Weight Lifting
        (Circle one)                                               Running  (HRM at 165 bpm)
                                                                        Biking     (HRM at 144 bpm)
                                                                        Other:  _____________________________ (Please list activity)

Signature of PE Teacher Supervising your make-up:  _____________________________________

**Make-up class may be performed before/after school or during a study hall with teacher permission. 
The NAI Fitness center is open Monday-Thursday from 2:30-4:00 pm.