January 23, 2019
 Student InfoP.E. Excuse Form     
 P.E. Excuse Form



Name:                                               Period:                  Date:                   

The purpose of the Excuse from Physical Education Form is to excuse your child from participating in class for a set period of time.  The Excuse from Physical Education Form must be filled out and signed by a parent/guardian.


Please excuse my child from Physical Education:


           Today and Tomorrow.

           For the next three days.

           Until                                        (date).

A doctor’s form is required for any illness or injury lasting more than three days.  Please attach your doctor’s form to this form, if required.


The reason for the excuse is related to an:



Personal excuse,s such as menstrual cramping will not be accepted as an excuse from participating in PE, unless a written doctor’s note requires your child to be excused from participating.


Please include more information regarding your child’s injury or illness.



In most cases, your child will still be required to participate in the stretching exercises and may walk the track while the rest of the class participates in the activity.  Please describe why your son/daughter should not participate in the stretching exercises and/or in walking around the track.





          Parent Signature /         Phone Number


Before turning in this form to your Physical Education teacher, you must turn it in to the office to be stamped and copied by the Health Assistant.


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