PERSONAL FITNESS TEST SCORE CARD
Name: ______________________________________________ Sex:__________ Age: _______
BODY MASS INDEX (BMI)
Height (meters) Weight (kilograms) BMI Classification
CARDIOVASCULAR ENDURANCE: 3-MINUTE STEP TEST COORDINATION: JUGGLING
1 Trial
st
Resting Heart Rate (BEFORE) ______ x 6
2nd Trial
Heart Rate (AFTER) ______ x 6
3rd Trial
STRENGTH: 90-DEGREE PUSH-UP TOTAL # OF PUSH-UPS: STRENGTH: BASIC PLANK TOTAL TIME:
5 33 and above EXCELLENT 5 51 seconds and above EXCELLENT
4 25 - 32 VERY GOOD
4 46 - 50 seconds VERY GOOD
3 17 - 24 GOOD
3 31 - 45 seconds GOOD
2 9 - 16 FAIR
2 16 - 30 seconds FAIR
1 1-8 NEEDS IMPROVEMENT
0 CANNOT EXECUTE POOR 1 1 - 15 seconds NEEDS IMPROVEMENT
RIGHT LEFT FLEXIBILITY: SIT AND REACH 1st Trial 2nd Trial
FLEXIBILITY: ZIPPER TEST
CM OVERLAPPED:
TOTAL CENTIMETERS:
5 Fingers overlapped by 6 cm and above. EXCELLENT
5 61 cm and above EXECELLENT
4 Fingers overlapped by 4 - 5.9 cm VERY GOOD
4 46 - 60.9 cm VERY GOOD
3 Fingers overlapped by 2 - 3.9 cm GOOD
3 31 - 15.9 cm GOOD
2 Fingers overlapped by 0.1 - 1.9 cm FAIR
1 Just touch the fingers NEEDS IMPROVEMENT 2 16 - 30.9 cm FAIR
0 Gap of 0.1 or wider POOR 1 0 - 15.9 cm NEEDS IMPROVEMENT
AGILITY: HEXAGON AGILITY TEST COUNTER CLOCKWISE POWER: STANDING LONG JUMP 1st Trial 2nd Trial
TOTAL SECONDS: TOTAL CENTIMETERS:
5 5 seconds and below EXECELLENT
5 201 cm and above EXECELLENT
4 6 - 10 seconds VERY GOOD
4 151 cm - 200 cm VERY GOOD
3 11 - 15 seconds GOOD
3 126 cm - 150 cm GOOD
2 16 - 20 seconds FAIR
1 21 - 25 seconds NEEDS IMPROVEMENT 2 101 cm - 125 cm FAIR
0 over 25 seconds POOR 1 55 cm - 100 cm NEEDS IMPROVEMENT
SPEED: 40-METER SPRINT
BOYS GIRLS
NUMBER OF SECONDS:
13-14 15-16 17-ABOVE 13-14 15-16 17-ABOVE
5 <5.0 <4.5 <4.0 <6.5 <5.5 <4.5 EXECELLENT
4 5.1 - 6.9 4.6 - 5.4 4.1 - 5.4 6.6 - 7.6 5.6 - 6.1 4.6 - 5.9 VERY GOOD
3 7.0 - 8.0 5.5 - 7.0 5.5 - 6.5 7.7 - 8.8 6.2 - 7.2 6.0 - 7.0 GOOD
2 8.1 - 9.1 7.1 - 8.1 6.6 - 7.5 8.9 - 9.5 7.3 - 8.5 7.1 - 8.1 FAIR
1 >9.2 >8.2 >7.6 >9.6 >8.6 >8.2 NEEDS IMPROVEMENT
BALANCE: STORK BALANCE STAND TEST RIGHT LEFT 1st Trial 2nd Trial 3rd Trial
REACTION TIME: STICK DROP TEST
13-14 15-16 17-ABOVE NUMBER OF SECONDS:
5 0 - 2.4 cm EXCELLENT
5 81 - 100 sec. 121 - 150 sec. 161 - 180 sec. EXECELLENT
4 5.08 - 10.16 cm VERY GOOD
4 61 - 80 sec. 91 - 120 sec. 121 - 160 sec. VERY GOOD
3 12.70 - 17.78 cm GOOD
3 41 - 60 sec. 61 - 90 sec. 81 - 120 sec. GOOD
2 20.32 - 25.40 cm FAIR
2 21 - 40 sec. 31 - 60 sec. 41 - 80 sec FAIR 1 27.94 - 30.48 cm NEEDS IMPROVEMENT
1 1 - 20 sec. 1 - 30 sec. 1 - 40 sec. NEEDS IMPROVEMENT 0 Did not catch POOR
PERSONAL FITNESS TEST SCORE CARD
Name: ______________________________________________ Sex:__________ Age: _______
BODY MASS INDEX (BMI)
Height (meters) Weight (kilograms) BMI Classification
CARDIOVASCULAR ENDURANCE: 3-MINUTE STEP TEST COORDINATION: JUGGLING
1 Trial
st
Resting Heart Rate (BEFORE) ______ x 6
2nd Trial
Heart Rate (AFTER) ______ x 6
3rd Trial
STRENGTH: 90-DEGREE PUSH-UP TOTAL # OF PUSH-UPS: STRENGTH: BASIC PLANK TOTAL TIME:
5 33 and above EXCELLENT 5 51 seconds and above EXCELLENT
4 25 - 32 VERY GOOD
4 46 - 50 seconds VERY GOOD
3 17 - 24 GOOD
3 31 - 45 seconds GOOD
2 9 - 16 FAIR
2 16 - 30 seconds FAIR
1 1-8 NEEDS IMPROVEMENT
0 CANNOT EXECUTE POOR 1 1 - 15 seconds NEEDS IMPROVEMENT
RIGHT LEFT FLEXIBILITY: SIT AND REACH 1st Trial 2nd Trial
FLEXIBILITY: ZIPPER TEST
CM OVERLAPPED:
TOTAL CENTIMETERS:
5 Fingers overlapped by 6 cm and above. EXCELLENT
5 61 cm and above EXECELLENT
4 Fingers overlapped by 4 - 5.9 cm VERY GOOD
4 46 - 60.9 cm VERY GOOD
3 Fingers overlapped by 2 - 3.9 cm GOOD
3 31 - 15.9 cm GOOD
2 Fingers overlapped by 0.1 - 1.9 cm FAIR
1 Just touch the fingers NEEDS IMPROVEMENT 2 16 - 30.9 cm FAIR
0 Gap of 0.1 or wider POOR 1 0 - 15.9 cm NEEDS IMPROVEMENT
AGILITY: HEXAGON AGILITY TEST COUNTER CLOCKWISE POWER: STANDING LONG JUMP 1st Trial 2nd Trial
TOTAL SECONDS: TOTAL CENTIMETERS:
5 5 seconds and below EXECELLENT
5 201 cm and above EXECELLENT
4 6 - 10 seconds VERY GOOD
4 151 cm - 200 cm VERY GOOD
3 11 - 15 seconds GOOD
3 126 cm - 150 cm GOOD
2 16 - 20 seconds FAIR
1 21 - 25 seconds NEEDS IMPROVEMENT 2 101 cm - 125 cm FAIR
0 over 25 seconds POOR 1 55 cm - 100 cm NEEDS IMPROVEMENT
SPEED: 40-METER SPRINT
BOYS GIRLS
NUMBER OF SECONDS:
13-14 15-16 17-ABOVE 13-14 15-16 17-ABOVE
5 <5.0 <4.5 <4.0 <6.5 <5.5 <4.5 EXECELLENT
4 5.1 - 6.9 4.6 - 5.4 4.1 - 5.4 6.6 - 7.6 5.6 - 6.1 4.6 - 5.9 VERY GOOD
3 7.0 - 8.0 5.5 - 7.0 5.5 - 6.5 7.7 - 8.8 6.2 - 7.2 6.0 - 7.0 GOOD
2 8.1 - 9.1 7.1 - 8.1 6.6 - 7.5 8.9 - 9.5 7.3 - 8.5 7.1 - 8.1 FAIR
1 >9.2 >8.2 >7.6 >9.6 >8.6 >8.2 NEEDS IMPROVEMENT
BALANCE: STORK BALANCE STAND TEST RIGHT LEFT 1st Trial 2nd Trial 3rd Trial
REACTION TIME: STICK DROP TEST
13-14 15-16 17-ABOVE NUMBER OF SECONDS:
5 0 - 2.4 cm EXCELLENT
5 81 - 100 sec. 121 - 150 sec. 161 - 180 sec. EXECELLENT
4 5.08 - 10.16 cm VERY GOOD
4 61 - 80 sec. 91 - 120 sec. 121 - 160 sec. VERY GOOD
3 12.70 - 17.78 cm GOOD
3 41 - 60 sec. 61 - 90 sec. 81 - 120 sec. GOOD
2 20.32 - 25.40 cm FAIR
2 21 - 40 sec. 31 - 60 sec. 41 - 80 sec FAIR 1 27.94 - 30.48 cm NEEDS IMPROVEMENT
1 1 - 20 sec. 1 - 30 sec. 1 - 40 sec. NEEDS IMPROVEMENT 0 Did not catch POOR
