PLEASE BRING IN AT EACH SESSION

INSTRUCTIONS TO KIDS AND PARENTS:

1.PLEASE INDICATE NUMBER OF JUMPROPES YOU CAN DO BEFORE YOU MISS. PLEASE TRY EVERY DAY FOR AT LEAST 20-30 MINUTES

2. PLEASE BRING THIS SHEET TO EACH MEETING AND HAVE INSTRUCTOR REVIEW AND SIGN BEFORE AT THE END OF EACH SESSION.

YOU WILL RECEIVE THE FOLLOWING FOR COMPLETING THIS FORM:

1. FOR BRINGING FORM IN AND RECORDING -1 TICKET FOR GRAND PRIZE SESSION 5.
2. IF YOU COMPLETE FROM SHOWING AN IMPROVEMENT FROM WEEK TO WEEK=2 TICKETS FOR GRAND PRIZE SESSION 5

END OF WEEK 1

HOW MANY WITHOUT MISSING-

HOW LONG DID YOU TRY IN MINUTES?

CHILD SIGNATURE/DATE-

PARENTS SIGNATURE/DATE

INSTRUCTOR SIGN OFF/DATE-

SUPERVISOR SIGN OFF/DATE

END OF WEEK 2

HOW MANY WITHOUT MISSING-

HOW LONG DID YOU TRY IN MINUTES?

CHILD SIGNATURE/DATE-

PARENTS SIGNATURE/DATE

INSTRUCTOR SIGN OFF/DATE-

SUPERVISOR SIGN OFF/DATE

END OF WEEK 3

HOW MANY WITHOUT MISSING-

HOW LONG DID YOU TRY IN MINUTES?

CHILD SIGNATURE/DATE-

PARENTS SIGNATURE/DATE

INSTRUCTOR SIGN OFF/DATE-

SUPERVISOR SIGN OFF/DATE

WEEK 4

HOW MANY WITHOUT MISSING-

HOW LONG DID YOU TRY IN MINUTES?

CHILD SIGNATURE/DATE-

PARENTS SIGNATURE/DATE

INSTRUCTOR SIGN OFF/DATE-

SUPERVISOR SIGN OFF/DATE 

WEEK 5

HOW MANY WITHOUT MISSING-

HOW LONG DID YOU TRY IN MINUTES?

CHILD SIGNATURE/DATE-

PARENTS SIGNATURE/DATE

INSTRUCTOR SIGN OFF/DATE-

SUPERVISOR SIGN OFF/DATE

CONGRATULATIONS AND REMEMBER, DO YOUR JUMP ROPE EVERY SINGLE DAY FOR AT LEAST 15-30 MINUTES!!

REMEMBER , WE ARE LOOKING FOR IMPROVEMENT TIME TO TIME AND THE ABILITY TO APPLY WHAT YOU LEARN TO YOUR DAILY LIFE.  WE INTEND THIS TO BE COMPLETELY NONJUDGEMENTAL AND NONTHREATENING FOR THE CHILDREN.  THE ONLY PERSON YOU ARE COMPETING AGAINST IS YOURSELF! GOOD LUCK AND HAVE FUN!!

PLEASE DO NOT WRITE BELOW THIS LINE

________________________________________________________________________

FOR INSTRUCTORS ONLY TO BE COMPLETED AT WEEK 5

TOTAL PERCENT IMPROVED FROM THE START